危重脓毒症患者预后的高危因素分析

Analysis of high risk factors for prognosis of severe sepsis patients

目的分析危重脓毒症患者的一般资料及生化指标,探讨影响危重脓毒症患者预后的高危因素。方法选取2008年9月至2018年9月四川省人民医院收治的1 013例危重脓毒症患者为研究对象,根据预后情况分为存活组(562例)和死亡组(451例),比较两组患者的一般资料、生化指标水平,采用多因素Logistic回归分析影响患者预后的独立危险因素。结果存活组年龄、APACHEⅡ评分低于死亡组(P<0.05)。存活组PCT及血乳酸水平明显低于死亡组(P<0.05);存活组血清白蛋白水平明显高于死亡组(P<0.05)。结论年龄、APACHEⅡ评分、血乳酸、PCT及血清白蛋白水平是影响危重脓毒症患者预后的独立危险因素,对早期预测和有效改善危重脓毒症患者预后具有重要临床价值。

Objective To analyze the clinical data and biochemical indicators of patients with severe sepsis, and to explore the high-risk factors affecting the prognosis of patients with severe sepsis. Methods A total of 1 013 patients with severe sepsis admitted in Sichuan People’s Hospital from September 2008 to September 2018 were selected as the study ob-jects. According to the prognosis, patients were divided into survival group(562 cases) and death group(451 cases). The general data and biochemical indexes levels of the two groups were compared, and the independent risk factors affecting the prognosis of the patients were analyzed by multivariate Logistic regression. Results Age and APACHEⅡ score in the survival group were lower than those in the death group(P<0.05). The levels of serum lactate acid and procalcitonin in the survival group were significantly lower than those in the death group(P<0.05). Serum albumin level in the survival group was significantly higher than that in the death group(P<0.05). Conclusion Age, APACHEⅡ score, blood lactate procalcitonin and serum albumin are the independent risk factors affecting the prognosis of severe sepsis patients, it has important clinical value for early prediction and effective improvement of the prognosis of severe sepsis patients.