脓毒症患者二尖瓣舒张早期峰流速与二尖瓣环舒张早期运动速度比值对预后的评估价值

发布时间：2018-06-20 07:16

本文选题：脓毒症 + 左心室舒张功能障碍　；参考：《山东医药》2017年06期

【摘要】：目的观察脓毒症患者二尖瓣舒张早期峰流速与二尖瓣环舒张早期运动速度比值(E/e')的变化,探讨其对脓毒症预后的评估价值。方法将82例脓毒症患者根据住院28 d内是否存活分为存活组59例和死亡组23例。分别于入ICU第1、3、7天行经胸壁超声心动图检查,应用组织多普勒成像(DTI)技术测定E/e'。应用多因素Logistic回归分析E/e'与脓毒症患者28 d病死率的相关性,利用受试者工作者特征曲线(ROC)分析E/e'对脓毒症患者28 d病死率的预测价值。结果死亡组E/e'入ICU第3、7天均高于第1天(P均0.05),第3天与第7天比较差异无统计学意义(P0.05)。存活组E/e'入ICU第3天高于第1天(P0.05);第7天较第3天降低(P0.05),与第1天比较差异无统计学意义(P0.05)。死亡组E/e'在第1、3、7天均较存活组明显增高(P均0.05)。Logistic回归分析显示,E/e'与脓毒症患者28 d病死率显著相关(P0.05),ROC分析显示,E/e'第1、3、7天评估脓毒症患者28 d病死率的曲线下面积分别为0.72、0.84、0.80,以第3天的E/e'值11.3为截点值,其预测28d病死率的敏感度为73.9%、特异度为72.9%。结论 E/e'是脓毒症患者28 d死亡的独立预测指标,有助于评估脓毒症患者的预后。
[Abstract]:Objective to observe the changes of mitral peak velocity and mitral annular early diastolic velocity ratio (E / E) in patients with sepsis and to evaluate the prognosis of sepsis. Methods Eighty-two patients with sepsis were divided into survival group (59 cases) and death group (23 cases) according to whether they survived in hospital for 28 days. Transthoracic echocardiography and tissue Doppler imaging (DTI) were performed on the 1st and 7th day after admission to ICU. Multivariate logistic regression analysis was used to analyze the correlation between Er / e' and fatality rate in sepsis patients at 28 days. The predictive value of Er / e' for 28 days mortality of sepsis patients was analyzed by means of roc. Results in the death group, the mean value of E / E'in ICU on the 3rd day was higher than that on the first day (P < 0.05), but there was no significant difference between the third day and the seventh day. In the survival group, the level of E / E'in ICU on the 3rd day was higher than that on the first day, and on the 7th day it was lower than that on the third day, but there was no significant difference between the survival group and the first day. In death group, E / E 'was significantly higher than that in survival group on day 1 and 3 (P < 0.05). Logistic regression analysis showed that there was a significant correlation between E / E' and mortality rate in sepsis patients at 28 days (P < 0.05). ROC analysis showed that E / E'on the 1st day of death was significantly higher than that in survival group (P < 0.05). Take the E / P 'value of 11.3 on the 3rd day as the cut-off point. The sensitivity and specificity in predicting the fatality rate of 28 days were 73.9 and 72.9 respectively. Conclusion Er\ -e' is an independent predictor of 28 days death in sepsis patients, which is helpful to evaluate the prognosis of sepsis patients.
【作者单位】：承德医学院附属医院;
【基金】：河北省科技支撑计划项目(152777205)
【分类号】：R459.7

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