CAJ | 학술논문

目的：讨论雌二醇、睾酮水平对妊娠合并脓毒症患者预后的影响。方法选取我院2012－12～2014－12产科ICU收治妊娠合并脓毒症患者39例。根据患者28 d生存情况分为生存组29例和死亡组10例，比较两组雌二醇、睾酮水平、年龄、体质量指数（ BMI）、APACHEⅡ评分和SOFA评分等临床指标，评价各指标对患者预后的预测价值。结果生存组血清雌二醇水平高于死亡组，睾酮水平、APACHEⅡ评分和SOFA评分均低于死亡组，差异有统计学意义（ P均＜0．05）。患者年龄、BMI等差异无统计学意义（P＞0．05）。通过Logistic回归分析及ROC曲线显示，血清睾酮水平、APACHEⅡ评分和SOFA评分是妊娠合并脓毒症早期患者预后的独立危险因素，且均对脓毒症患者预后有较好的预测价值，临界点为血清睾酮水平0．64 pmol／L时，敏感度（86％）、特异度（84％）最高。结论性激素水平对妊娠合并脓毒症早期患者的预后有显著影响，睾酮水平可作为预测妊娠合并脓毒症早期患者预后的临床指标。
목적：토론자이순、고동수평대임신합병농독증환자예후적영향。방법선취아원2012－12～2014－12산과ICU수치임신합병농독증환자39례。근거환자28 d생존정황분위생존조29례화사망조10례，비교량조자이순、고동수평、년령、체질량지수（ BMI）、APACHEⅡ평분화SOFA평분등림상지표，평개각지표대환자예후적예측개치。결과생존조혈청자이순수평고우사망조，고동수평、APACHEⅡ평분화SOFA평분균저우사망조，차이유통계학의의（ P균＜0．05）。환자년령、BMI등차이무통계학의의（P＞0．05）。통과Logistic회귀분석급ROC곡선현시，혈청고동수평、APACHEⅡ평분화SOFA평분시임신합병농독증조기환자예후적독립위험인소，차균대농독증환자예후유교호적예측개치，림계점위혈청고동수평0．64 pmol／L시，민감도（86％）、특이도（84％）최고。결론성격소수평대임신합병농독증조기환자적예후유현저영향，고동수평가작위예측임신합병농독증조기환자예후적림상지표。
Objective To investigate whether the estradiol, testosterone levels affect the prognosis of pregnant patients with early sepsis. Methods Thirty -nine pregnant patients who accompanied with sepsis from Dec 2012 to Dec 2014 in obstetric ICU of our hospital were selected in this study.According to patients with 28 d survival situation, 10 cases were included into survival group and 29 cases were included into death group.The data between the two groups were analyzed, including the level of estradiol and testosterone, age, body mass index ( BMI ) and APACHEⅡ scores, clinical indexes such as SOFA score, evaluation of each index forecast the prognosis of patients with valid values.Results Serum estradiol level in the survival group was higher than that in the death group, but serum testosterone level, APACHEⅡscore, SOFA scores were lower in the survival group than those in the death group, the difference was statistically significant (P <0.05).There were no significant statistical difference in age, BMI of the patients(P>0.05).ROC curve by Logistic regression analysis has shown that the serum testosterone level, APACHEⅡ scores, SOFA score were independent risk factors for the prognosis of pregnant patients with early sepsis, and they can well predict the prognosis. The critical point for serum testosterone level was 0.64 pmol/L with a sensitivity of 86% and a specificity of 84% which was highest among the above mentioned risk factors.Conclusion Sex hormone levels in pregnant patients with early sepsis have remarkable effect on the prognosis.And we recommend the serum testosterone level to be a clinical indicator for predicting the prognosis of pregnant patients with early sepsis.