休克指数对脓毒症并肾功能不全患者血流动力学评价

Hemodynamic evaluation of the shock index in patients with sepsis and renal insufficiency

目的研究休克指数对连续性血液净化治疗脓毒症患者的血流动力学状态的评价作用并进行分析。方法选取从2015年3月至2016年3月,于我院接受治疗的脓毒症患者56例。根据患者是否合并慢性肾功能不全分为多种因素诱发急性肾损伤患者组27例(A组),慢性肾功能不全合并其他疾病患者组29例(B组)。两组患者均给予连续性血液净化治疗,分别于治疗前1 h及治疗后1、3、6 h观察两组患者收缩压、舒张压、心率以及休克指数变化情况,同时随访记录治疗28 d后的死亡率。结果治疗前1 h,A组收缩压、舒张压均显著低于B组,而各个时间段内A组心率均明显高于B组;不同时间段A组休克指数均显著高于B组,以上差异均有统计学意义(P<0.05)。A组治疗后28 d死亡率为40.74%,B组为31.03%,差异无统计学意义(P>0.05)。结论休克指数可用于动态评估连续性血液净化治疗脓毒症合并肾功能不全患者的血流动力学状态。

Objective To investigate the evaluation value of shock index in patients with sepsis treated with continuous blood purification therapy. Methods 56 patients with sepsis were enrolled for the study, and were divided into group A （27 cases with acute kidney injury ） and group B （29 cases with chronic renal insufficiency ）. Two groups of patients were given continuous blood purification treatment. 1 h before and after treatment for 1, 3 and 6 h the two groups of patients were recorded for the systolic blood pressure, diastolic blood pressure, heart rate, and shock index changes. Patients were followed up for 28 d and mortality was recorded. Results 1 h before treatment, systolic pressure and diastolic blood pressure of group A were significantly lower than those of group B ; and the heart rates of group A measured at different time point were significantly higher than those of group B （P〈0.05）. The shock indexes of group A at different time points were significantly higher than those of group B （P〈0.05）. The mortality rate of group A at 28 d after treatment was 40.74%, and group B was 31.03%, the difference was not statistically significant （P〉0.05）. Conclusion Shock index could be used for dynamic evaluation of continuous blood purification treatment of sepsis with renal insufficiency.