某三甲医院ICU患者发生败血症的危险因素分析

目的分析某三甲医院重症监护病房(intensive care uni,ICU)患者发生败血症的危险因素。方法回顾性选取2021年1月—2023年12月在广西壮族自治区南溪山医院ICU住院的186例患者的临床资料,收集并比较败血症和非败血症患者的一般资料,并使用多因素二元Logistic回归分析ICU患者发生败血症的危险因素。结果186例ICU住院患者中有22例患者感染败血症,164例患者未感染败血症,败血症发生率为11.83%(22/186)。败血症患者和非败血症患者的年龄、糖尿病、慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)、侵入性操作、预防性应用抗生素、意识障碍、中心静脉导管相关性血流感染、急性生理学与慢性健康状况评分系统Ⅱ(Acute Physiology and Chronic Health Evalution Scoring System,APACHEⅡ)和血白蛋白浓度情况比较,差异有统计学意义(P均<0.05)。多因素二元Logistic回归分析结果显示,存在糖尿病(OR=2.045,95%CI:1.067~4.226)、存在COPD(OR=1.034,95%CI:1.005~1.132)、有侵入性操作(OR=3.657,95%CI:2.344~6.827)、有预防性应用抗生素(OR=4.882,95%CI:3.274~7.954)、存在意识障碍(OR=2.167,95%CI:1.602~3.167)、存在中心静脉导管相关性血流感染(OR=1.065,95%CI:1.003~2.147)、APACHEⅡ评分(OR=3.471,95%CI:2.141~7.443)和血白蛋白浓度(OR=1.473,95%CI:1.117~1.826)是ICU患者发生败血症的独立危险因素(P均<0.05)。结论影响ICU患者发生败血症的主要因素有存在糖尿病、存在COPD、有侵入性操作、有预防性应用抗生素、存在意识障碍、中心静脉导管相关性血流感染、高APACHEⅡ评分和低血白蛋白浓度,针对以上因素给予患者的针对性预防,可降低败血症的发生率。

密度仪检测法用于人血白蛋白含量测定

蛋白含量是人血白蛋白等血液制品的关键性生化指标.<中国生物制品规程>(2000年版)规定成品的蛋白含量检测必须使用定氮法[1～3].定氮法虽然精确度高,但操作极其烦琐,且检测时间长,不适合血液制品生产的半成品蛋白含量检测.故现在血液制品生产厂家对人血白蛋白半成品蛋白含量检测,建立了多种蛋白浓度的快速检测方法,如双缩脲法[1～4]、折射仪检测法[5]、紫外分光法、染料法[6,7]等.下面,笔者介绍利用溶液密度的差异检测蛋白浓度的快速检测方法,并对可能影响此方法检测结果的因素进行探讨.

Effect of hypoxia on the blood of large yellow croaker (Pseudosciaena crocea)

Large areas of hypoxic water have recently been reported in the East China Sea. It is hypothesized that hypoxia may be partially responsible for the decline of some fish stocks. We evaluated the effect of hypoxia on large yellow croaker (Pseudosciaena crocea). The fish were exposed to three concentrations of dissolved oxygen (DO; 1.5 mg/L and 2.0 mg/L, and 6.5 mg/L control). We collected blood after 6, 12, 24, 48, and 96 h exposure. There was a significant increase in red blood count, hematocrit, hemoglobin concentration, and mean corpuscular hemoglobin in the group exposed to 1.5 mg/L DO after 6 h or 12 h, and a delayed increase (only elevated after 48 h and 96 h) in these indices in the group exposed to 2.0 mg/L DO. Plasma glucose concentrations increased significantly in both hypoxic groups after 24 h. Furthermore, plasma lactate and lactate dehydrogenase activity increased significantly after the first 6 h exposure in both hypoxic groups. Our results suggest that large yellow croakers could not maintain the aerobic pathway and instead use anaerobic metabolism for survival when DO levels fall below 2.0 mg/L. We conclude that the occurrence of hypoxia (<2 mg/L DO) in the East China Sea could cause metabolic stress for large yellow croakers and may be partially responsible for the population decline of this species.

Therapeutic Efficacy of Quinapyramine Sulphate with Freund＇s Complete Adjuvant in Wistar Rats Infected with Trypanosoma Congolense

Therapeutic efficacy of QS （quinapyramine sulphate） and FCA （Freund＇s complete adjuvant） combination was studied. The aim of the study was to evaluate therapeutic efficacy of QS using FCA in Trypanosorna congolense infection. GrouPs treated with QS and FCA had parasite disappeared in peripheral circulation 2 days pi, relapse was observed one week later. Effect of treatment on rectal temperature shows no significance （p 〈 0.05）, normalization of rectal temperature occurred in QS and FCA treated groups （34.1℃） than untreated （42.8 ℃）, QS （37.4 ℃） and FCA （35.92 ℃） treated groups. Mean body weight was significant （p 〈 0.001） in QS and FCA, QS, and FCA groups. Packed cell volume and hemoglobin concentration for untreated groups were lower, but increased in QS, FCA, QS and FCA treated groups, indicating anemia amelioration. White blood cell counted in untreated, QS and FCA treated groups showed no significance （p 〈 0.05）, however, there was leukocytosis due to lymphocytosis in QS and FCA treated group （6.79 × 10^3/μl） compared with untreated and other groups. There was comparative decrease in serum liver enzymes in QS and FCA treated group than other groups. Therefore, QS at lower recommended dose with FCA may enhance efficacy of QS in trypanosomiasis.