代谢综合征对脓毒症患者病情及预后的影响

Effect of metabolic syndrome on conditions and prognosis of patients with sepsis

目的探讨代谢综合征(MS)对脓毒症患者病情严重程度及预后的影响。方法选取2014年1月-2016年12月该院治疗的脓毒症患者330例作为研究对象。根据是否合并MS将患者分为MS组和非MS组,对两组一般资料、急性生理和慢性健康状态评价系统Ⅱ(APACHEⅡ)评分、序贯器官衰竭评估(SOFA)评分、脓毒性休克发生率、多器官功能障碍综合征(MODS)发生率、住院时间及28 d病死率进行比较;采用多因素Logistic回归分析MS各因素对脓毒症患者预后的影响。结果 MS组SOFA评分和降钙素原(PCT)水平高于非MS组(P<0.05);MS组脓毒性休克发生率和MODS发生率高于非MS组(P<0.05),与非MS组比较,MS组住院时间延长、病死率增加(P<0.05)。将MS作为一项危险因素进入多因素Logistic回归模型,显示MS对脓毒症患者不良预后的发生有预测作用[OR=1.675(95%CI:1.024,2.336),P=0.036]。结论 MS可加重脓毒症患者病情,提高并发症的发生率。

Objective To investigate the effects of metabolic syndrome on the severity and prognosis in patients with sepsis.Methods A total of 330 patients with sepsis admitted into our department from January 2014 to December 2016 were enrolled and were divided into MS group and non-MS group.Basic clinical data,acute physiology and chronic health evaluation(APACHE II)score,sequential organ failure assessment(SOFA)score,morbidity,morbidity of multiple organ dysfunction syndrome(MODS),hospitalization stay and the 28-day mortality were recorded.Logistic regression analysis was performed to determine effect of MS on prognosis in the patients with sepsis.Results SOFA score,procalcitonin(PCT),incidence of septic shock and MODS in the MS group were significantly increased compared with non-MS group.Compared with non-MS group,the hospitalization stay and the mortality wereincreased enhanced.Logistic regression analysis indicated that MS was an independent risk factor of poor prognosis(P<0.05).Conclusions Metabolic syndrome is closely correlated with the severity and prognosis of sepsis.