舌下微循环变化与脓毒症患者疾病严重程度、预后的关系分析

Analysis of the relationship between the changes of sublingual microcirculation and the severity and prognosis of sepsis

目的探讨并分析舌下微循环变化与脓毒症患者疾病严重程度、预后的关系。方法选取2020年2月~2021年2月在本院确诊的脓毒症患者64例。根据预后情况分为生存组(48例)和死亡组(16例),根据病情严重程度分为严重脓毒症患者(21例)和脓毒症组(43例),比较各组患者的灌注血管密度(PVD)、灌注血管比例(PPV)、微血管流动指数(MFI)、血管密度(TVD)等舌下微循环指标;记录各组患者的急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分及入住重症监护病房(ICU)的时间。结果生存组患者的PVD、PPV、MFI、TVD等舌下微循环水平均显著高于死亡组(P<0.05);生存组患者的APACHEⅡ评分及入住ICU时间均显著低于死亡组(P<0.05);严重脓毒症组患者的PVD、PPV、MFI、TVD等舌下微循环水平均显著低于脓毒症组(P<0.05);严重脓毒症组患者的APACHEⅡ评分及入住ICU时间均显著高于脓毒症组(P<0.05);APACHEⅡ与PPV呈现负相关关系(P<0.05),与PVD、MFI、TVD无相关性(P>0.05)。结论PPV对评估患者的预后及疾病的严重程度具有积极意义。

Objective To explore and analyze the relationship between the changes of sublingual microcirculation and the severity and prognosis of sepsis.Methods 64 patients with sepsis diagnosed in our hospital from February 2020 to February 2021 were selected.According to the prognosis,they were divided into survival group(48 cases)and death group(16 cases).According to the severity of the disease,they were divided into severe sepsis patients(21 cases)and sepsis group(43 cases).The perfusion vessel density(PVD),perfusion vessel ratio(PPV),microvascular flow index(MFI),vascular density(TVD)and other sublingual microcirculation indicators of each group were compared;The scores of acute physiology and chronic health condition scoring systemⅡ(APACHEⅡ)and the time of admission to intensive care unit(ICU)were recorded.Results The levels of PVD,PPV,MFI and TVD in the survival group were significantly higher than those in the death group(P<0.05);APACHEⅡscore and ICU stay time in survival group were significantly lower than those in death group(P<0.05);The levels of PVD,PPV,MFI,TVD and other sublingual microcirculation in severe sepsis group were significantly lower than those in sepsis group(P<0.05);APACHEⅡscore and ICU stay time in severe sepsis group were significantly higher than those in sepsis group(P<0.05);APACHEⅡwas negatively correlated with PPV(P<0.05),but not with PVD,MFI,TVD(P>0.05).Conclusions PPV has positive significance in evaluating the prognosis of patients and the severity of the disease.