脓毒症患者血压变异率与病情危重程度的关系研究

Relationship between blood pressure variability rate and extent of critically in ill patients with sepsis

目的探讨脓毒症患者血压变异率与病情危重程度的关系。方法以2012年5月~2013年4月我院收治的60例脓毒症患者为研究对象,分为APACHE-Ⅱ≥20分(危重组)和APACHE-Ⅱ<20分(非危重组),选取同期到我院接受体检的健康者30例(对照组)。比较危重组与非危重组患者的24 h SBP-CV、24 h DBP-CV、d SBP-CV、d DBP-CV、n SBP-CV、n DBP-CV变异率,对血压变异率与APACHE-Ⅱ评分进行相关性分析。比较三组患者的高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、白介素-6(IL-6)、白介素-18(IL-18)。结果危重组APACHE-Ⅱ评分为(29.56±0.79)分,非危重组APACHE-Ⅱ评分为(13.15±0.58)分。两组SBP变异率比较差异具有统计学意义(P<0.05)。Spearman分析结果显示,24 h SBP-CV、d SBP-CV、n SBP-CV变异率与APACHE-Ⅱ评分呈正相关(r=0.762,P=0.003)。危重组、非危重组、对照组的HDL-C、LDL-C依次升高,IL-6、IL-18依次降低,组间差异具有统计学意义(P<0.05)。结论患者血压变异率与脓毒症危重程度呈明显正相关,其机制可能是促进IL-6、IL-18等炎性因子分泌,扩大炎症反应。

Objective To investigate the Relationship between blood pressure variability rate and extent of critically in ill patients with sepsis. Methods From May 2012 to April 2013 in our hospital, 60 cases of sepsis patients for the study were divided into APACHE-Ⅱ≥20 points(critical group) and APACHE-Ⅱ<20 minutes(non-critical group), selected the same period to our hospital for medical examination of 30 cases of healthy subjects(control group). The risk and non-risk reorganization reorganization patients 24 h SBP-CV,24 h DBP-CV,d SBP-CV,d DBP-CV,n SBP-CV, n DBPCV mutation rate, mutation rate and blood pressure APACHE- Ⅱ score correlation analysis. Comparison of the three groups of patients with high-density protein cholesterol(HDL-C), low-density protein cholesterol(LDL-C), interleukin-6(IL-6), interleukin-18(IL-18) were compared. Results The danger of recombinant APACHE-Ⅱ score was(29.56±0.79), non dangerous recombinant APACHE- Ⅱ score was(13.15 ±0.58). Two groups of SBP mutation rate comparison, with statistically significant difference(P<0.05). Spearman analysis showed that 24 h SBP-CV,d SBP-CV,n SBP-CV, related to the mutation rate and APACHE-Ⅱ score was positively(r=0.762, P=0.003). Critical group, non critical group, control group HDL-C, LDL-C gradually increased, IL-6, IL-18 were lower, with statistically significant difference between the two groups(P<0.05). Conclusion The rate and blood pressure variability in the degree of sepsis in critically ill patients was positively correlated, the mechanism may be the promotion of IL-6, inflammatory kookiness such as IL-18 secretion, and expand the inflammatory response.