重症患者血清皮质醇浓度与APACHEⅡ评分的相关性

Correlation between serum cortisol level and APACHE II score in critically ill patients

目的研究重症患者皮质醇浓度与病情转归和APACHEⅡ评分的关系。方法113例重症患者根据血清皮质醇浓度分为皮质醇正常组和皮质醇增高组，分析两组患者死亡率，同时对各组皮质醇浓度和APACHEⅡ评分的相关性进行分析。结果皮质醇正常组和皮质醇增高组死亡率比较差异有统计学意义（χ2=105．21，P〈0．01）；皮质醇正常组APACHEⅡ评分为（20±7）分，皮质醇增高组为（30±6）分，两组比较差异有统计学意义（P〈0．01）。皮质醇正常组皮质醇浓度与APACHEⅡ评分无明显相关（r=-0．234，P=0．095），皮质醇增高组皮质醇浓度与APACHEⅡ评分呈弱正相关（r=0．301，P=0．018）。结论皮质醇高浓度的重症患者有较高的死亡风险和较高的APACHEⅡ评分。

Objective To investigate the relationship of cortisol concentration with the outcome of patients and acute physiology and chronic health evaluation lI （ APACHE I1 ） score. Methods 113 critically ill patients were divided into normal cortisol group and enhanced cortisol group according to serum cortisol concentration. The mortality of two groups was analyzed and tested through χ2 test. Meanwhile, the relationship between serum cortisot concentration and APACHE II score was analyzed. Results The mortality had obvious differences between normal cortisol group and enhanced cortisol group（χ2 = 105.21, P 〈 0.01 ）. APACHE I1 score of normal cortisol group was （ 20 ± 7 ）, enhanced cortisol group was （30 ± 6）, there were apparent differences in two groups（ P 〈 0.01 ）. Serum eortisol was not obviously relative to APACHE I1 score in normal eortisol group （r = -0.234, P = 0.095 ）, while it had a weak positive correlation with APACHE II score in enhanced cortisol group （ r = 0. 301, P = 0.018）. Conclusion Critically ill patient with enhanced cortisol had higher possibility of death and higher APACHE II score.