谷氨酸水平评估脓毒症急性肝功能损害患者预后的临床价值

The Level of Plasma Glutamate Contributes to The Survival in Sepsis with Liver Dysfunction

目的:研究血清谷氨酸(Glu)水平与脓毒症早期急性肝功能障碍预后的相关性。方法:前瞻观察2007年1月—2007年12月因脓毒症急性肝功能障碍进入复旦大学附属中山医院急诊ICU50例患者的SOFA评分、血清谷氨酸/谷氨酰胺(Glu/Gln)浓度比值及患者预后的相关资料。将患者分成存活组和死亡组,评价血清Glu/Gln浓度比值脓毒症患者预后的关系。结果:与存活组相比,脓毒症死亡组血清Glu显著降低;与存活组相比,脓毒症死亡组血清Glu/Gln浓度比值亦降低。结论:血清Glu浓度降低以及Glu/Gln比例的降低可用于评估脓毒症急性肝功能障碍患者的预后。

Objective： To evaluate the correlation between the prognosis and the concentration of plasma glutamate in patients with sepsis induced liver dysfunction. Methods：The clinical data of 50 patients with severe sepsis induced liver dysfunction admitted to Zhongshan Hospital of Fudan University between Jan. 2007 and Dec. 2007 was analyzed prospectively. SOFA score, the mortality rate and the plasma concentration of glutamate and glutamine were measured. The patients were divided into survival group and nonsurvival group. Results： Glutamate concentrations were consistently and significantly lower in non-survivors compared to surviving septic patients. Plasma Glu to Gln ratio was consistently lower in non survivors compared to survivors. Conclusion：Patients who die of sepsis with acute liver dysfunction can be predicted by significantly lowered plasma glutamate concentrations and lowered glutamate to glutamine ratio.