重症监护室血源性危重脓毒症患者的病原菌分布及其预后分析

Analysis of pathogenic fungus distribution and prognosis in patients with bloodstream infection critically ill sepsis in intensive care unit

目的:探讨ICU血源性危重脓毒症的致病菌分布特点,分析影响患者预后的危险因素,旨在为提高ICU血源性危重脓毒症的救治水平提供经验。方法:回顾性分析中山大学附属中山医院重症医学科2008年1月至2015年1月严重脓毒症、脓毒症休克患者的临床资料,如病例基本资料、生化指标及病原菌分布等,按出院时的结局将其分为院内死亡组和康复出院组,通过Logistic回归模型确定影响预后的独立危险因素。结果:2008年1月至2015年1月中山大学附属中山医院符合脓毒症诊断标准的患者4 638例,血源性危重脓毒症870例,年龄(48±12)岁,男560例,康复出院558例,Logistic回归方程提示APACHEⅡ评分、年龄、降钙素原、血乳酸及血清白蛋白是影响预后的独立危险因素。结论:ICU血源性危重脓毒症具有较高的病死率,APACHEⅡ评分、年龄、降钙素原、血乳酸及血清白蛋白是影响其预后的高危因素。

Objective To analyze the pathogenic fungus distribution and the risk factors affecting the prognosis in patients with bloodstream infection critically ill sepsis in intensive care unitso as to provide evidence for clinical treatment. Methods From January 2008 to January 2015, the clinic data of patients with severe sepsis and septic shock were retrospectively studied. The factors affecting the prognosiswere found out using a multivariate logistic regression analysis. Results From January 2008 to January 2015, there were 870 bloodstream infection critically ill sepsis. Risk factors affecting the prognosis of critically ill sepsis patients were as follows： serum albumin, age, APACHE V and procalcitonin. Conclusion Bloodstream infection critically ill sepsis in intensive care unit contributes a high motality. APACHE Ⅱ , age, blood lactate, procalcitonin , blood lactate and serum albumin are the risk factors affecting the prognosis of critically ill sepsis patients.