摘要
目的通过分析老年脓毒性休克患者肌红蛋白含量及清除率在治疗过程中的变化,探讨肌红蛋白与老年脓毒性休克患者病情严重程度及预后的关系。方法采用回顾性病例对照研究,选取2020年1月至2021年5月北京王府中西医结合医院急诊科脓毒性休克患者25例,平均年龄78.12±11.8岁,作为研究对象,普通肺炎患者25例,平均年龄81.8±10.1岁,作为参考对象;从以下两个方面进行探讨,一是肌红蛋白含量与脓毒症病情严重程度相关性:将脓毒性休克患者入院后7d内死亡患者作为实验组,脓毒性休克生存患者作为对照组;二是肌红蛋白清除率与预后的关系:(1)将脓毒性休克组中的死亡患者作为脓死亡组,好转患者作为脓生存组;(2)将普通肺炎组中的死亡患者作为普死亡组,好转患者作为普生存组。收集数据并分析,比较肌红蛋白、中性粒细胞数、PCT三者在脓毒性休克患者与普通肺炎患者中的变化情况,间接反应肌红蛋白对于脓毒性休克的诊疗价值。收集患者基本信息和临床资料,采用SPSS 20.0软件进行统计学分析。结果肌红蛋白含量:(1)从肌红蛋白含量与脓毒症病情严重程度相关性来看,患者病情越重,肌红蛋白含量越高;(2)从肌红蛋白含量在脓毒性休克患者与普通肺炎患者的对比来看,脓毒性休克组肌红蛋白含量明显高于普通肺炎组。肌红蛋白清除率:在脓毒性休克组中,脓生存组肌红蛋白清除率明显高于脓死亡组;在普通肺炎组中,同样普生存组肌红蛋白清除率明显高于普死亡组,比较差异均有统计学意义(P<0.05)。结论肌红蛋白含量越高,脓毒性休克患者病情越严重;肌红蛋白清除率与脓毒性休克患者预后正相关,即肌红蛋白清除率越高,脓毒性休克患者预后越好。
Objective To investigate the relationship between myoglobin and severity and prognosis of senile patients with septic shock by analyzing the changes of myoglobin content and clearance rate during treatment.Methods A retrospective case-control study was used to select 25 patients with septic shock in the emergency department of Beijing Wangfu Integrated Traditional Chinese and Western Medicine Hospital from January 2020 to May 2021,with an average age of 78.12±11.8 years.The age of 81.8±10.1 years old was used as the reference object;the following two aspects were discussed.First,the correlation between the content of myoglobin and the severity of sepsis:patients with septic shock who died within 7 days after admission were taken as the experimental group.Toxic shock survival patients were taken as the control group;second,the relationship between myoglobin clearance and prognosis:(1)The dead patients in the septic shock group were taken as the pus death group,and the improved patients were taken as the pus survival group;(2)The death patients in the common pneumonia group were taken as the pus survival group;The patients were regarded as the general death group,and the improved patients were regarded as the general survival group.Data were collected and analyzed to compare the changes of myoglobin,neutrophil count,and PCT in patients with septic shock and those with common pneumonia,which indirectly reflected the value of myoglobin in the diagnosis and treatment of septic shock.The basic information and clinical data of the patients were collected,and SPSS 20.0 software was used for statistical analysis.Results Myoglobin content:(1)From the perspective of the correlation between myoglobin content and the severity of sepsis,the more severe the patient’s condition,the higher the myoglobin content;(2)From the comparison of myoglobin content in septic shock patients and ordinary pneumonia patients,the myoglobin content in the septic shock group was significantly higher than that in the ordinary pneumonia group.Myoglobin clearance rate:in the septic shock group,The myoglobin clearance rate in the pus survival group was significantly higher than that in the pus death group;in the common pneumonia group,the myoglobin clearance rate in the general survival group was significantly higher than that in the general death group,and the differences were statistically significant(P<0.05).Conclusions The higher the myoglobin content is,the more serious the condition of septic shock patients is.The myoglobin clearance rate is positively correlated with the prognosis of patients with septic shock,that is,the higher the myoglobin clearance rate,the better the prognosis of patients with septic shock.
作者
张国鹏
马明
黄鑫
寇明凤
康博
王仲
Zhang Guopeng;Ma Ming;Huang Xin;Kou Mingfeng;Kang Bo;Wang Zhong(Beijing Royal Hospital of Integrated Traditional Chinese and Western Medicine,Emergency;Clinical School of Medicine,Tsinghua University,Tsinghua Changgeng Hospital,General medicine,Beijing,China)
