文章摘要
尹彦芬,容维娜,张 霞,赵国栋,王胜磊,李晓峰,张惠祺,刘月宣.脓毒症患者血清氧化应激因子、炎症因子水平与APACHEⅡ评分及预后的关系研究[J].,2021,(3):524-528
脓毒症患者血清氧化应激因子、炎症因子水平与APACHEⅡ评分及预后的关系研究
Study on the Relationship between Serum Levels of Oxidative Stress Factor and Inflammatory Factor, APACHE II Score and Prognosis in Patients with Sepsis
投稿时间:2020-04-23  修订日期:2020-05-18
DOI:10.13241/j.cnki.pmb.2021.03.026
中文关键词: 脓毒症  氧化应激因子  炎症因子  APACHEⅡ评分  预后  相关性
英文关键词: Sepsis  Oxidative stress factor  Inflammatory factor  APACHE II score  Prognosis  Correlation
基金项目:河北省医学科学研究重点课题计划项目(20181022)
作者单位E-mail
尹彦芬 河北医科大学附属人民医院/石家庄市第一医院急诊科 河北 石家庄 050000 15132130820@126.com 
容维娜 河北医科大学附属人民医院/石家庄市第一医院急诊科 河北 石家庄 050000  
张 霞 河北医科大学附属人民医院/石家庄市第一医院急诊科 河北 石家庄 050000  
赵国栋 河北医科大学附属人民医院/石家庄市第一医院急诊科 河北 石家庄 050000  
王胜磊 河北医科大学附属人民医院/石家庄市第一医院急诊科 河北 石家庄 050000  
李晓峰 河北医科大学附属人民医院/石家庄市第一医院急诊科 河北 石家庄 050000  
张惠祺 河北医科大学附属人民医院/石家庄市第一医院急诊科 河北 石家庄 050000  
刘月宣 河北医科大学附属人民医院/石家庄市第一医院神经内科 河北 石家庄 050000  
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中文摘要:
      摘要 目的:探讨脓毒症患者血清氧化应激因子、炎症因子水平与急性生理学与慢性健康状况II(APACHEⅡ)评分及预后的关系。方法:选择2016年1月-2019年10月我院收治的脓毒症患者76例作为研究组,同期收治的相同基础疾病非脓毒症患者60例作为对照组,比较两组血清氧化应激因子[丙二醛(MDA)、超氧化物歧化酶(SOD)、一氧化氮(NO)]、炎症因子[降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素27(IL-27)]水平及APACHEⅡ评分,根据脓毒症患者预后将其分为死亡组25例、存活组51例,比较两组上述指标,并分析脓毒症患者预后的影响因素及血清氧化应激因子、炎症因子水平与APACHEⅡ评分的相关性。结果:研究组血清MDA、PCT、CRP、IL-27及APACHEⅡ评分显著高于对照组,血清SOD、NO显著低于对照组(P<0.05)。死亡组血清MDA、PCT、CRP、IL-27及APACHEⅡ评分显著高于存活组,血清SOD、NO显著低于存活组 (P<0.05)。多因素logistic回归分析显示MDA升高、SOD降低、NO降低、PCT升高、CRP升高、APACHEⅡ评分升高均是脓毒症患者死亡的危险因素(OR=2.293、1.872、1.527、2.472、1.667、1.926,P<0.05)。Pearson相关性分析显示,脓毒症患者血清MDA、PCT、CRP、IL-27水平与APACHEⅡ评分呈正相关(r=0.563、0.582、0.441、0.302,P<0.05),血清NO、SOD水平与APACHEⅡ评分呈负相关(r=-301、-0.386,P<0.05)。结论:脓毒症患者血清MDA、PCT、CRP、IL-27与APACHEⅡ评分异常升高,血清NO、SOD异常降低,可能通过对上述指标进行检测从而判断患者病情及评估其预后。
英文摘要:
      ABSTRACT Objective: To explore the relationship between the prognosis and the levels of serum oxidative stress factor, inflammatory factor, acute physiology and chronic health II (APACHE II) in patients with sepsis. Methods: 76 patients with sepsis who were admitted to our hospital from January 2016 to October 2019 were selected as study group, 60 patients with non sepsis of the same basic disease as control group. The serum oxidative stress factors [Malondialdehyde (MDA),superoxide dismutase (SOD),nitric oxide (NO)], inflammatory factors [procalcitonin (PCT), C-reactive protein (CRP), interleukin 27 (IL-27)] and APACHE II score were compared between the two groups. According to the prognosis of sepsis patients, the patients were divided into two groups: the dead group (25 cases) and the living group (51 cases). The above indexes were compared between the two groups. The influencing factors of the prognosis of sepsis patients and the correlation between the levels of serum oxidative stress factor and inflammatory factor and Apache Ⅱ were analyzed. Results: The levels of MDA, PCT, CRP, IL-27 and ApacheⅡscore in the study group were significantly higher than those in the control group, and the levels of SOD and NO in the study group were significantly lower than those in the control group(P<0.05). The scores of MDA, PCT, CRP, IL-27 and Apache Ⅱscore in the dead group were significantly higher than those in the alive group, and the levels of SOD and NO in the dead group were significantly lower than those in the alive group (P<0.05). Multivariate logistic regression analysis showed that MDA increased, SOD decreased, NO decreased, PCT increased, CRP increased, APACHE II increased were the risk factors of sepsis death (OR=2.293, 1.872, 1.527, 2.472, 1.667, 1.926, P<0.05). Pearson correlation analysis showed that MDA, PCT, CRP, IL-27 were positively correlated with Apache Ⅱ score(r=0.563, 0.582, 0.441, 0.302, P<0.05), while NO, SOD were negatively correlated with Apache Ⅱ score (r=-301, -0.386, P<0.05). Conclusion: The levels of MDA, PCT, CRP, IL-27 and APACHE II in patients with sepsis increased abnormally, and the levels of NO and SOD decreased abnormally, it is possible to judge the patient's condition and evaluate the prognosis by detecting the above indexes.
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