中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
27期
39-41
,共3页
脓毒症%肝疾病%危险因素%内皮缩血管肽类
膿毒癥%肝疾病%危險因素%內皮縮血管肽類
농독증%간질병%위험인소%내피축혈관태류
Sepsis%Liver diseases%Risk factors%Endothelins
目的 对比脓毒症诱发急性肝功能障碍的危险因素及相关临床特征.方法 将168例脓毒症患者按是否诱发急性肝功能障碍分为单纯脓毒症组(对照组,142例)和脓毒症诱发肝功能障碍组(观察组,26例).比较两组生化指标、血浆内皮素(ET)-1、脓毒症相关的序贯器官衰竭评分(SOFA)等,并分析诱发急性肝功能障碍可能的危险因素.结果 168例脓毒症患者急性肝功能障碍发生率为15.5％ (26/168).观察组总胆红素、直接胆红素、肌酐、血糖波动范围、动脉血乳酸、血浆ET-1、SOFA、病死率均明显高于对照组[(35.9 ±9.8)μmol/L比(27.8 ±6.7) μμmol/L、(17.7±8.0)μμ mol/L比(12.3±5.9)μmol/L、(219.6±156.4) μmol/L比(159.4±125.3) μmol/L、(7.6±4.9)mmol/L比(3.0±1.6) mmol/L、(3.8±1.3) mmol/L比(2.0±1.2) mmol/L、(79.6±25.7) μg/L比(60.8±12.6) μμg/L、(8.8±2.6)分比(5.7±1.8)分、38.5％(10/26)比17.6％(25/142)],差异有统计学意义(P＜ 0.01或＜0.05).多因素Logistic回归分析显示,长期饮酒、心功能不全以及低血压为脓毒症诱发急性肝功能障碍的独立危险因素.结论 脓毒症诱发急性肝功能障碍的患者具有较高的动脉血乳酸、血浆ET-1和SOFA,且长期饮酒、心功能不全以及低血压为危险因素.
目的 對比膿毒癥誘髮急性肝功能障礙的危險因素及相關臨床特徵.方法 將168例膿毒癥患者按是否誘髮急性肝功能障礙分為單純膿毒癥組(對照組,142例)和膿毒癥誘髮肝功能障礙組(觀察組,26例).比較兩組生化指標、血漿內皮素(ET)-1、膿毒癥相關的序貫器官衰竭評分(SOFA)等,併分析誘髮急性肝功能障礙可能的危險因素.結果 168例膿毒癥患者急性肝功能障礙髮生率為15.5％ (26/168).觀察組總膽紅素、直接膽紅素、肌酐、血糖波動範圍、動脈血乳痠、血漿ET-1、SOFA、病死率均明顯高于對照組[(35.9 ±9.8)μmol/L比(27.8 ±6.7) μμmol/L、(17.7±8.0)μμ mol/L比(12.3±5.9)μmol/L、(219.6±156.4) μmol/L比(159.4±125.3) μmol/L、(7.6±4.9)mmol/L比(3.0±1.6) mmol/L、(3.8±1.3) mmol/L比(2.0±1.2) mmol/L、(79.6±25.7) μg/L比(60.8±12.6) μμg/L、(8.8±2.6)分比(5.7±1.8)分、38.5％(10/26)比17.6％(25/142)],差異有統計學意義(P＜ 0.01或＜0.05).多因素Logistic迴歸分析顯示,長期飲酒、心功能不全以及低血壓為膿毒癥誘髮急性肝功能障礙的獨立危險因素.結論 膿毒癥誘髮急性肝功能障礙的患者具有較高的動脈血乳痠、血漿ET-1和SOFA,且長期飲酒、心功能不全以及低血壓為危險因素.
목적 대비농독증유발급성간공능장애적위험인소급상관림상특정.방법 장168례농독증환자안시부유발급성간공능장애분위단순농독증조(대조조,142례)화농독증유발간공능장애조(관찰조,26례).비교량조생화지표、혈장내피소(ET)-1、농독증상관적서관기관쇠갈평분(SOFA)등,병분석유발급성간공능장애가능적위험인소.결과 168례농독증환자급성간공능장애발생솔위15.5％ (26/168).관찰조총담홍소、직접담홍소、기항、혈당파동범위、동맥혈유산、혈장ET-1、SOFA、병사솔균명현고우대조조[(35.9 ±9.8)μmol/L비(27.8 ±6.7) μμmol/L、(17.7±8.0)μμ mol/L비(12.3±5.9)μmol/L、(219.6±156.4) μmol/L비(159.4±125.3) μmol/L、(7.6±4.9)mmol/L비(3.0±1.6) mmol/L、(3.8±1.3) mmol/L비(2.0±1.2) mmol/L、(79.6±25.7) μg/L비(60.8±12.6) μμg/L、(8.8±2.6)분비(5.7±1.8)분、38.5％(10/26)비17.6％(25/142)],차이유통계학의의(P＜ 0.01혹＜0.05).다인소Logistic회귀분석현시,장기음주、심공능불전이급저혈압위농독증유발급성간공능장애적독립위험인소.결론 농독증유발급성간공능장애적환자구유교고적동맥혈유산、혈장ET-1화SOFA,차장기음주、심공능불전이급저혈압위위험인소.
Objective To study the risk factors and clinical features on acute hepatic dysfunction induced by sepsis.Methods One hundred and sixty-eight patients with sepsis were divided into 2 groups according to liver function:simple sepsis group (control group,142 cases) and acute hepatic dysfunction induced by sepsis group (observation group,26 cases).The biochemical indicators,plasma endothelin (ET)-1,sepsis-related organ failure assessment (SOFA) were compared between 2 groups.The risk factors of inducing acute hepatic dysfunction were analyzed.Results The incidence of acute hepatic dysfunction in 168 patients with sepsis was 15.5％ (26/168).The total bilirubin,direct bilirubin,creatinine,range of blood glucose variation,arterial blood lactic acid,plasma ET-1,SOFA,fatality rate in observation group were significantly higher than those in control group [(35.9 ±9.8) μμmol/L vs.(27.8 ±6.7) μmol/L,(17.7 ± 8.0) μ mol/L vs.(12.3 ± 5.9) μ mol/L,(219.6 ± 156.4) μ mol/L vs.(159.4 ± 125.3) μ mol/L,(7.6 ±4.9) mmol/L vs.(3.0 ± 1.6) mmol/L,(3.8 ± 1.3) mmol/L vs.(2.0 ± 1.2) mmol/L,(79.6 ±25.7)μg/L vs.(60.8 ± 12.6) μg/L,(8.8 ±2.6) scores vs.(5.7 ± 1.8) scores,38.5％ (10/26) vs.17.6％(25/142)],there were statistical differences (P ＜ 0.01 or ＜ 0.05).Multifactor Logistic regression analysis results showed that long-term drinking,cardiac insufficiency and hypotension were independent risk factors of acute hepatic dysfunction induced by sepsis.Conclusions The arterial blood lactic acid,plasma ET-1 and SOFA in patients with acute hepatic dysfunction induced by sepsis are higher.Long-term drinking,cardiac insufficiency and hypotension are the risk factors of acute hepatic dysfunction induced by sepsis.
