中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2012年
4期
351-355
,共5页
重症监护室%感染%尿酸%尿素氮%肌酐%肺炎%中枢神经系统感染%肾功能不全%预后
重癥鑑護室%感染%尿痠%尿素氮%肌酐%肺炎%中樞神經繫統感染%腎功能不全%預後
중증감호실%감염%뇨산%뇨소담%기항%폐염%중추신경계통감염%신공능불전%예후
Intensive care unit%Infection%Uric acid%Blood urea nitrogen%Creatinine%Pneumonia%Central nervous system infection%Renal insufficiency%Prognosis
目的 探讨重症监护室(ICU)感染患者中基础血清尿酸水平的分布及其与预后的关系.方法 回顾性收集2003年1月至2010年4月收住华山医院中心ICU且存在感染的患者共471例.入选标准:入院时或住院过程中明确诊断有单、多部位感染的患者.记录患者入院24 h血清尿酸、肌酐、尿素氮测量值及其他临床资料,描述尿酸的分布,并以t检验等分析评估尿酸与基础疾病的相关性.对不同尿酸水平病例进行分组,运用x2检验比较其预后等特征差异.P＜0.05为差异有统计学意义.结果 (1)入院24h内的尿酸值为(0.232±0.131) mmol/L(中位数0.199mmol/L).(2)尿酸值在以下基础疾病中的分布有显著变化:高血压(t=-3.084,P=0.002)、糖尿病(t=-2.487,P=0.013)、脑梗死(t=-3.061,P=0.002)、肾功能不全(t=-4.547,P＜0.01)、中枢神经系统感染(t=5.096,P＜0.01)和外伤(t=2.875,P=0.004).(3)血尿酸与肌酐和尿素氮均有直线相关性(P＜0.01,F值分别为159.470,165.059).(5)基础尿酸水平与感染患者预后之间无统计学意义x2 =60.892,P=0.100).结论 本研究发现基础尿酸水平与ICU患者感染的预后没有直接相关性.
目的 探討重癥鑑護室(ICU)感染患者中基礎血清尿痠水平的分佈及其與預後的關繫.方法 迴顧性收集2003年1月至2010年4月收住華山醫院中心ICU且存在感染的患者共471例.入選標準:入院時或住院過程中明確診斷有單、多部位感染的患者.記錄患者入院24 h血清尿痠、肌酐、尿素氮測量值及其他臨床資料,描述尿痠的分佈,併以t檢驗等分析評估尿痠與基礎疾病的相關性.對不同尿痠水平病例進行分組,運用x2檢驗比較其預後等特徵差異.P＜0.05為差異有統計學意義.結果 (1)入院24h內的尿痠值為(0.232±0.131) mmol/L(中位數0.199mmol/L).(2)尿痠值在以下基礎疾病中的分佈有顯著變化:高血壓(t=-3.084,P=0.002)、糖尿病(t=-2.487,P=0.013)、腦梗死(t=-3.061,P=0.002)、腎功能不全(t=-4.547,P＜0.01)、中樞神經繫統感染(t=5.096,P＜0.01)和外傷(t=2.875,P=0.004).(3)血尿痠與肌酐和尿素氮均有直線相關性(P＜0.01,F值分彆為159.470,165.059).(5)基礎尿痠水平與感染患者預後之間無統計學意義x2 =60.892,P=0.100).結論 本研究髮現基礎尿痠水平與ICU患者感染的預後沒有直接相關性.
목적 탐토중증감호실(ICU)감염환자중기출혈청뇨산수평적분포급기여예후적관계.방법 회고성수집2003년1월지2010년4월수주화산의원중심ICU차존재감염적환자공471례.입선표준:입원시혹주원과정중명학진단유단、다부위감염적환자.기록환자입원24 h혈청뇨산、기항、뇨소담측량치급기타림상자료,묘술뇨산적분포,병이t검험등분석평고뇨산여기출질병적상관성.대불동뇨산수평병례진행분조,운용x2검험비교기예후등특정차이.P＜0.05위차이유통계학의의.결과 (1)입원24h내적뇨산치위(0.232±0.131) mmol/L(중위수0.199mmol/L).(2)뇨산치재이하기출질병중적분포유현저변화:고혈압(t=-3.084,P=0.002)、당뇨병(t=-2.487,P=0.013)、뇌경사(t=-3.061,P=0.002)、신공능불전(t=-4.547,P＜0.01)、중추신경계통감염(t=5.096,P＜0.01)화외상(t=2.875,P=0.004).(3)혈뇨산여기항화뇨소담균유직선상관성(P＜0.01,F치분별위159.470,165.059).(5)기출뇨산수평여감염환자예후지간무통계학의의x2 =60.892,P=0.100).결론 본연구발현기출뇨산수평여ICU환자감염적예후몰유직접상관성.
Objective To explore the clinical implications of the initial levels of serum uric acid (SUA) after admission in the critically ill patients with infection,and to investigate the relationship between SUA and prognosis of infection.Methods From January 2003 to April 2010,471 patients with infection were admitted to the ICU of Huashan Hospital,Fudan University,Shanghai.Data,including serum uric acid (SUA),serum creatinine,blood urea nitrogen (BUN) and other relevant laborartory results within 24hours after admission,were retrospectively analyzed.The distribution of uric acid was described.The t test was used to evaluate the relation between SUA and preexisting disorders.Patients with different level of SUA were classfied for further analysis.x2 test was used to examine the difference in the prognosis of infection.Results The mean initial level of SUA within 24 hours after admission was 0.232 ± 0.131 mmol/L and the median 0.199 mmol/L. Remarkable difference in initial levels of SUA were observed in patients with preexisting hypertension (t=-3.084,P=0.002),diabetes mellitus (t=-2.487,P=0.013),cerebral infarction (t=-3.061,P=0.002),renal insufficiency (t=-4.547,P＜0.01),central nervous system infection (t =5.096,P ＜ 0.01 ) and trauma (t =2.875,P =0.004).Serum uric acid was linearly correlated with serum creatinine and blood urea nitrogen (F =159.470 and 165.059,respectively; P ＜0.01).No statistical correlation was found between initial levels of SUA and prognosis of infection (x2=60.892,P=0.100).Conclusions There is no direct correlation between the initial levels of SUA afteradmission and the prognosis of infection in the critically ill patients.
