急性肺栓塞患者血清钠水平波动与临床预后的相关性研究

The correlation analysis between fluctuation of serum sodium and prognosis in patients with acute pulmonary embolism

目的探讨血清钠水平的波动对急性肺栓塞(APE)患者预后的影响。方法将在巴中市中心医院治疗的64例APE患者根据患者预后分为存活组(n=42)和死亡组(n=22),分别于治疗前和入院后第3、7天检测血清钠水平,综合分析血清钠水平波动与患者预后的关系。结果死亡组患者血清钠水平低于存活组,差异有统计学意义(P<0.05);受试者工作特征曲线分析显示,Δ血清钠水平、Qanadli栓塞指数对患者死亡有一定的预测价值;Δ1(治疗后3d-治疗前)、Δ2(治疗后7d-治疗前)和Δ3(治疗后7d-治疗后3d)血清钠水平与死亡发生呈正相关(P<0.05)。Δ2和Δ3血清钠水平与Qanadli栓塞指数呈正相关(P<0.05);Qanadli栓塞指数(OR=1.28,95%CI0.92~1.48,P<0.05)和Δ3血清钠水平(OR=1.28,95%CI 0.99~1.75,P<0.05)为APE患者死亡发生的独立危险因素。结论血清钠水平波动对APE患者的死亡预后有一定预测价值和相关性。

Objective To investigate the correlation between fluctuation of serum sodium and prognosis in patients with acute pulmonary embolism（APE）.Methods Sixty four APE patients in Bazhong Central Hospital were enrolled in this study and divided into two group：survival group（n=42）and death group（n=22）based on clinical prognosis.The level of serum sodium were analyzed before treatment and days after admission in third,seventh,the relationship between fluctuation of serum sodium and prognosis of patients was analyzed.Results The level of serum sodium in death group were significantly lower than those in survival group（P〈0.05）.ROC analysis showed that the level ofΔsodium and Qanadli index had a predictive value for mortality.The levels of secrum sodium ofΔ1（3dafter treatment-before treatment）,Δ2（7dafter treatment-before treatment）andΔ3（7dafter treatment-3dafter treatment）were positively associated to death（P〈0.05）.The levels of secrum sodium ofΔ2andΔ3were positively associated with Qanadli index（P〈0.05）.Qanadi mdex andΔ3were the independent risk factor for death occurred in patients with APE（OR=1.28,95%CI0.92-1.48,P〈0.05;OR=1.28,95%CI0.99-1.75,P〈0.05）.Conclusion The fluctuation of secrum sodium has certain prediction value and relevance for death in patients with APE.