摘要
目的:探讨感染性休克患者中肾素-血管紧张素系统的变化和意义。方法:对21例感染性休克患者和24例非感染性休克患者分别测定血浆肾素活性(PRA)和AngⅡ浓度,以及血乳酸水平(LAC),并进行急性生理及慢性健康状况(APACHE)Ⅱ评分和序贯器官功能衰竭评分(SOFA),计算病死率,进一步将患者按预后分为死亡组和存活组进行分析,对结果进行比较,并对PRA、AngⅡ浓度和APACHEⅡ评分、SOFA评分、LAC进行相关分析。结果:与非感染性休克组相比,感染性休克组患者PRA、AngⅡ、APACHEⅡ、SOFA评分、LAC和病死率明显增高;与存活组患者相比,死亡组患者PRA、AngⅡ、APACHEⅡ、SOFA评分、LAC明显升高(P<0.05)。相关分析结果,PRA和APACHEⅡ、SOFA、LAC之间相关系数分别为0.409、0.601和0.671(P<0.01);AngⅡ和APACHEⅡ、SOFA、LAC之间相关系数分别为0.491、0.776和0.690(P<0.01)。结论:感染性休克激活了肾素-血管紧张素系统,PRA和AngⅡ浓度明显升高,过度激活的肾素-血管紧张素系统可能参与器官功能损伤过程,PRA和AngⅡ水平与病情严重程度相关性较好,对病情预后和严重程度判断有重要作用。
Objective： To investigate the variation and value of renin - angiotensin system （RAS） in patients with septic shock. Methods：We studied 21 patients with septic shock and 24 patients with non - septic shock, assessed all patients with A- PACHE Ⅱ score system and the Sequential Organ Failure Assessment （SOFA） system. Furthermore, all patients were divided into two groups（ survival vs dead） by prognosis. Plasma renin activity （PRA） and angiotensin （Ang） Ⅱ concentration in serum was assayed u- sing a commercial radioimmune assay （RIA） kit. A Pearson correlation coefficient was calculated to compare linear relationships be- tween PRA ,Ang Ⅱand APACHE Ⅱ s, SOFAs, and LAC. Results： Compared with non - septic shock group , PRA and Ang Ⅱ were significantly elevated in group with septic shock. The mortality, APACHE Ⅱ scores, SOFA scores , and LAC in septic group was higher than the non - septic group. Compared with survival group , PRA and Ang Ⅱ were significantly elevated in dead group. PRA was found a positive correlation with APACHE Ⅱ s,SOFAs ,and LAC（ r =0. 409,0.601 and 0. 671 ）, Ang Ⅱ was also found a positive cor- relation with APACHE IT s , SOFAs , and LAC （ r = 0. 491, 0. 776 and 0. 690）. Conclusion： RAS is activated in septic shock , PRA and AngⅡconcentration in serum were Elevated, PRA and Ang Ⅱ concentration correlate with organ failure and severity in patients with septic shock.
出处
《中国中西医结合肾病杂志》
2013年第1期48-51,共4页
Chinese Journal of Integrated Traditional and Western Nephrology
基金
浙江省温州市科技局基金资助项目(No.Y20110167)
