血清皮质醇水平变化在脓毒症患者中的重要临床意义

Clinical significance of serum cortisol level changes in patients with sepsis

目的探讨血清皮质醇水平变化在脓毒症患者中的重要临床意义。方法纳入的脓毒症患者103例作为观察对象,根据预后生存情况分为生存组86例与死亡组17例。另选择体检健康者80例作为对照组。所有研究对象均于入院后第2天清晨空腹抽取外周静脉血,分离血清,用酶联免疫吸附法测定血清皮质醇水平。比较两组和不同预后组急性生理与慢性健康(APACHEⅡ)评分、序贯器官衰竭(SOFA)评分和血清皮质醇变化,及APACHEⅡ评分和SOFA评分与皮质醇相关性。结果研究组APACHEⅡ评分、SOFA评分和血清皮质醇水平高于对照组,差异有统计学意义(P<0.05)。死亡组APACHEⅡ评分、SOFA评分和血清皮质醇水平高于生存组,差异有统计学意义(P<0.05)。APACHEⅡ评分和SOFA评分与皮质醇呈线性正相关关系。结论血清皮质醇水平在脓毒症患者中明显升高,且随着预后不断进展其水平升高越明显,值得临床借鉴。

Objective To investigate the clinical significance of serum cortisol levels in sepsis patients.Methods The 103 sepsis patients were selected as the observation objects.According to the prognosis and survival,they were divided into survival group(86 cases)and death group(17 cases).Another 80 health examinees in our hospital were selected as the control group.The peripheral venous blood was taken from all subjects on the morning of the 2nd day after admission,and the serum was separated.The serum cortisol level was determined by ELISA.The correlation between APACHEⅡscore,SOFA score and serum cortisol,APACHEⅡscore and SOFA score and cortisol was compared between two groups and different prognostic groups.Results The APACHEⅡscore,SOFA score and serum cortisol level in the study group were higher than those in the control group,and the difference was statistically significant(P<0.05).APACHEⅡscore,SOFA score and serum cortisol level in the death group were higher than those in the survival group(P<0.05),and the difference was statistically significant(P<0.05).APACHEⅡscore and SOFA score were positively correlated with cortisol.Conclusion Serum cortisol level in patients with sepsis increased significantly,and with the continuous progress of prognosis,the higher the level is,the more obvious it is,which is worthy of clinical reference.