感染性休克患者血清淀粉酶与疾病严重程度及预后的关系

Relationship of serum amylase and severity of illness and prognosis in patients with septic shock

目的探讨感染性休克患者血清淀粉酶水平与疾病严重程度及预后的关系。方法45例感染性休克患者,根据28d生存情况分为生存组(23例)和死亡组(22例),检测第1天和第2天的血清淀粉酶水平,采用急性生理学及慢性健康状况评分(APACHEⅡ评分)和全身感染相关性器官功能衰竭评分(SOFA评分)评估疾病严重程度和预后,并分析血清淀粉酶水平与APACHEⅡ评分、SOFA评分的相关性。结果第1天和第2天,生存组血清淀粉酶水平分别为(122.4±100.2)U/L和(137.8±110.1)U/L,均低于死亡组的(221.3±169.7)U/L和(288.2±197.3)U/L(P<0.05)。第1天,生存组APACHEⅡ评分和SOFA评分均低于死亡组(P<0.05)。所有患者第1天的血清淀粉酶水平与APACHEⅡ评分和SOFA评分呈正相关(r=0.954和0.836,P<0.05)。结论感染性休克患者常见淀粉酶水平升高,与疾病严重程度相关,并能提示患者的预后。

Objective To investigate the relationship of serum amylase and the severity of illness and prognosis in the patients with septic shock. Methods A total of 45 patients with septic shock was divided into two groups of A（survival group, 23 eases） and B（death group, 22 cases） according to whether the patients were alive or not in 28 days. Serum level of amylase was measured on the 1st and 2nd day. The severity of illness and prognosis were estimated by the Acute Physiology and Chronic Health Evaluation II（APACHE II ） and Sepsis-related Organ Failure Assessment （SOFA）. The relationship of serum amylase and the severity of illness and prognosis was analyzed. Restflts Serum levels of amylase on the 1st and 2nd day were lower in group A than those in group B [（122. 4±100. 2） U/L vs. （221.3±169. 7） U/L and （137. 8±10. 1） U/L vs. （288. 2±197. 3） U/L] （P〈0. 05）. The scores of APACHEII and SOFA on the 1st day were lower in group A than those in group B（P〈0. 05）. Serum level of amylase was positively correlated with APACHEII and SOFA on the 1st day in the patients with septic shock （ r = 0. 954 and 0. 836, P〈0. 05 ）. Conclusion Higher serum amylase level is common in the patients with septic shock, which is correlated with the severity of illness and may be taken as an indicator for predicting the prognosis.