微量清蛋白尿检测在预测ICU重症患者并发重症脓毒症中的临床价值探讨

Clinical value of microalbuminuria testing on predicting severe sepsis in severe patients in ICU

目的为提高临床诊断率,了解微量清蛋白尿检测在预测ICU重症患者并发重症脓毒血症中的临床应用价值。方法选择2009年1月-2010年12月ICU收住的60例重症患者,并发重症脓毒血症的23例分为Ⅱ组,无并发重症脓毒血症者分为Ⅰ组。结果Ⅱ组患者,确诊>24hACR阳性率为78.3%,确诊>48hACR阳性率为82.6%,确诊24h和48h后ACR阳性率显著高于Ⅰ组,差异有统计学意义(P<0.05);Ⅱ组患者,确诊>24hACR值平均为(25.3±5.5)mg/mmol,确诊>48hACR值平均为(27.5±8.2)mg/mmol,确诊24h和48h后ACR值显著高于Ⅰ组,差异有统计学意义(P<0.05)。结论尿微量清蛋白水平持续升高提示有严重感染发生,微量清蛋白尿检测可作为预测ICU重症患者并发重症脓毒血症的一个指标。

OBJECTIVE To improve the clinical diagnosis rate, to understand the value of clinical applications of microalbuminuria testing in predicting severe patients in ICU with severe sepsis. METHODS A total of 60 cases of severe patients in the ICU rescued in our department between Jan 2009 and Dec 2010 were selected. 23 cases of patients with severe sepsis were divided into Ⅱ group, and the patients without complicated sever sepsis were included into Ⅰ group. RESULTS More than 24 hours after being diagnosed,positive proportions of ACR of Ⅱ groups of patients was 78.3% ,and 48 hours after being diagnosed,that was 82.6%. 24 hours and 48 hours after being diagnosed,positive proportions of ACR of Ⅱ groups of patients was higher than that of I groups of patients （P〈0.05）. The value of ACR of ACR of Ⅱ groups of patients was （25.3±5.5）mg/mmol 24 hours after being diagnosed,and at 48 hours after being diagnosed, that was （27.5±8.2）mg/mmol. 24 hours and 48 hours after being diagnosed,value of ACR of Ⅱ groups of patients was higher than that of l groups of patients （P〈0.05）. CONCLUSION The continuous rising level of microalbuminuria indicates a serious infection, microalbuminuria testing is considered as an indicator predicting severe patients in ICU with severe sepsis.