硝酸甘油治疗脓毒性休克患者效果的影响因素分析

Influencing factors analysis of the effect of nitroglycerin in the treatment of patients with septic shock

目的分析硝酸甘油治疗脓毒性休克患者效果的影响因素。方法回顾性选取2014年至2015年在本院重症医学科住院并接受硝酸甘油治疗的脓毒性休克患者为研究对象，以乳酸清除率为因变量，以基线各参数为白变量进行多因素Logistic回归分析。结果多因素Logistic回归分析显示，对乳酸清除率的独立影响因素有初始血乳酸（OR=1．68，95％CI：1．25—5．93，P〈0．05）、中心静脉血氧饱和度（OR=2．85，95％CI：1．67—8．42，P〈0．05）、动脉与脉搏氧饱和度差值（Oft=4．65，95％CI：2．32—11．67，P〈0．05）。结论基线乳酸水平较高、中心静脉血氧饱和度异常升高、动脉与脉搏氧饱和度差值增大的脓毒性休克患者硝酸甘油治疗有效。

Objective To analyze the influencing factors for therapeutic efficacy of nitroglycerin in patients with septic shock. Methods Patients with septic shock who were treated with nitroglycerin in ICU of our hospital from 2014 to 2015 were enrolled. To assess the influencing factors for therapeutic efficacy, a multivariate logistic regression analysis was performed, taking lactate clearance rate as a dependent variable, and baseline parameters as independent variables. Result Multivariate logistic regression analysis indicated that baseline lactic acid （OR=1.68, 95%CI： 1.25-5.93, P〈0.05）, ScvO2 （OR=2.85, 95%CI： 1.67-8.42, P〈0.05）, Sa-PO2 （OR=4.65, 95%CI： 2.32-11.67, P〈0.05） were independent influencing factors for lactate clearance rate. Conclusion Nitroglycerin may be more effective in patients with septic shock with higher baseline lactic acid, ScvO2, and Sa-pO2.