中介素在脓毒症合并肝损伤患者中的变化及其对预后的影响

Changes of intermedin in patients with sepsis accompanied with liver injury and its effect on prognosis

目的:探讨血清中介素对脓毒症合并肝损伤患者预后的影响。方法:选择2017年1月~2020年6月中日友好医院收治的90例脓毒症合并肝损伤患者作为研究对象,另选择40例单纯脓毒症患者和40例健康体检者作为对照。比较各组的中介素水平。根据入院后28d内的生存状态将患者分为死亡组和生存组,采用多因素回归分析脓毒症合并肝损伤患者预后的影响因素。结果:脓毒症合并肝损伤组的中介素水平显著高于脓毒症组(P<0.05)。血清中介素水平在轻度、中度和重度肝损伤脓毒症组的差异均有统计学意义(P<0.05)。死亡组的重度肝损伤程度和意识障碍的发生率、中介素水平和APACHEⅡ评分均显著高于生存组,BMI显著低于生存组。重度肝损伤、意识障碍、高中介素水平、高APACHEⅡ评分是脓毒症合并肝损伤患者死亡的危险因素(P<0.01)。结论:血清中介素水平与脓毒症合并肝损伤患者临床预后密切相关,可作为评估预后的潜在指标。

Objective:To investigate the effect of intermedin on the prognosis of sepsis accompanied with liver injury.Methods:Nighty patients with sepsis and liver injury from January 2017 to June 2020 were selected as the subjects.In addition,40 patients with simple sepsis and 40 patients with health examination were selected as the control groups.According to the degree of liver function injury,all sepsis patients with liver injury were divided into three groups:mild liver injury sepsis group,moderate liver injury sepsis group and severe liver injury sepsis group.The levels of intermedin were compared between groups.Patients were divided into death group and survival group according to the survival status within 28 days after admission.The clinical basic characteristics of patients with sepsis accompanied with liver injury were compared between the survival group and the death group,and multivariate regression was used to analyze the factors influencing the prognosis of patients with sepsis accompanied with liver injury.Results:The level of intermedin in sepsis combined with liver injury group was significantly higher than that in sepsis group(P<0.05).The level of intermedin was significantly different among the mild,moderate,and severe liver injury sepsis groups.The severity of severe liver injury and the incidence of disturbance of consciousness in the death group were significantly higher than those in the survival group.The level of intermedin and APACHE II score in the death group were significantly higher than those in the survival group. BMI in the death group was significantly lower than that in the survival group.Severe liver injury,disturbance of consciousness,high levels of intermedin,and high APACHE II score are risk factors for death in patients with sepsis accompanied with liver injury(P<0.01).Conclusion:The level of intermedin is closely related to the clinical prognosis of patients with sepsis accompanied with liver injury and can be used as a potential indicator for prognostic evaluation.