早期低磷血症对重症患者预后的影响

The Effect of Early Hypophosphoremia on the Prognosis of Critically ill Patients

目的观察ICU早期低磷血症的发生率及对医院生存率的影响。方法2017年1-12月ICU患者,记录24 h内血磷水平、APACHEⅡ评分。将所有患者分为轻、中、重度低血磷症组和正常血磷组。观察早期低磷血发生率、各组间医院生存率。比较生存、死亡组血磷水平、APACHEⅡ评分。结果105例患者,低血磷43例,正常62例,低血磷发生率40.95%,轻度低血磷18例、中度21例、重度4例。低血磷组医院生存率较正常组低,血磷水平越低医院生存率越低。低血磷组APACHEⅡ评分较正常组高,APACHEⅡ评分与血磷水平呈显著负相关,血磷水平越低APACHEⅡ评分越高。105例患者生存55例,死亡50例,生存组的中位数血磷水平为0.960 mmol/L,死亡组的中位数血磷水平0.675 mmol/L,生存组较死亡组血磷水平高。结论重症患者早期易发生低血磷,血磷水平是重症患者预后指标之一。

Objective To investigate the incidence of early hypophosphatemia in ICU and its effect on hospital survival rate.Methods From January to December2017,the levels of blood phosphorus and APACHEn scores in24hours were recorded in ICU patients.All patients were divided into mild,moderate and severe hypophosphatemia group and normal blood phosphorus group.The incidence of early hypophosphatemia and the hospital survival rate among groups were observed.The blood phosphorus levels and APACHE II scores in survival and death groups were compared.Results Among105patients,43patients were hypophosphatemia,62patients were normal,the incidence of hypophosphatemia was40.95%,18patients were mild hypophosphatemia,21patients were moderate hypophosphatemia and4patients were severe hypophosphatemia.The hospital survival rate of the low blood phosphorus group was lower than that of the normal group,and the lower the blood phosphorus level was,the lower the hospital survival rate was.The APACHE II score in the hypophosphatemia group was higher than that in the normal group.The APACHE II score was negatively correlated with the blood phosphorus level.The lower the blood phosphorus level,the higher the APACHE II score.Of105patients,55survived and50died.The median blood phosphorus level in survival group was0.960mmol/L,while that in death group was0.675mmol/L.The level of blood phosphorus in survival group was higher than that in death group.Conclusion Critically ill patients are prone to be hypophosphoremia in the early stage and serum phosphate level is the prognostic indicator for them.