摘要
[目的]探讨血清白蛋白(ALB)及血尿素氮(BUN)指标变化对急性呼吸窘迫综合征(ARDS)患者预后的影响。[方法]收集沈阳军区总医院呼吸内科重症监护室(RICU)30例ARDS患者临床资料,根据患者临床预后分为死亡组及存活组,比较患者血清ALB及BUN变化对患者临床预后的影响。[结果]30例患者中,死亡20例,存活10例。两组患者在性别、年龄、是否合并下呼吸道感染、诱发因素、确诊时的APACHEⅡ评分及氧合指数等的比较差异无显著性意义(P>0.05)。死亡组与存活组患者的ALB基础值(确诊时)比较差异均无统计学意义(P>0.05),但在第5、7天时两组比较差异具有显著性意义(t=-2.88,P=0.01,t=-3.83,P=0.00,P<0.05);存活组治疗第7天与基础值比较差异有统计学意义(t=-2.15,P=0.045,P<0.05),第5、7天与第3天比较差异也有统计学意义(t=-2.81,P=0.01,t=-2.95,P=0.01,P<0.05),但死亡组无明显改变;存活组ALB随住院天数延长而增高。死亡组患者BUN基础值及治疗第5、7天与存活组比较差异均有统计学意义(t=2.39,P=0.02,t=2.16,P=0.04,t=2.19,P=0.04,P<0.05);存活组第5、7天与第3天比较差异有统计学意义(t=-2.81,P=0.01,t=2.35,P=0.03,P<0.05),而死亡组无明显改变。BUN基础值在正常范围的患者两组之间比较差异无统计学意义(P>0.05),基础值异常患者两组间比较差异有统计学意义(t=2.13,P=0.046,P<0.05)。[结论]动态观察ARDS患者ALB、BUN变化,有助于判断患者临床预后。
[ Objective l To discuss the effects of ALB and Bun on the prognosis of the acute respiratory distress syndrome （ARDS） . [ Methods] Thirty ARDS patients admitted in Respiratory Intensive Care Unit （RICU） of the General Hospital of Shenyang Military Region were collected and analyzed. According to the clinical prognosis, the patients were divided into death and survival groups. The effects of ALB and Bun variation on the clinical prognosis were examined. [ Results ] Twenty cases of ARDS patients died and 10 cases survived. There were no significant differences （ P 〉 0.05 ） between the death and survival groups in gender, age,induced factors, and the accompanied lower respiratory tract infection, APACHE 1I score and PaO2/FiO2 of the baseline value （ when diagnosed）. There were no significant difference （ P 〉 0.05 ） between the death and survival groups in ALB baseline value （when diagnosed）. The ALB level was significantly difference between the death and survival groups on day 5 ,day 7 （t = -2. 88 ,P =0. 01 ,t = -3.83 ,P =0. 00,P 〈0.05）. There was significant difference between the baseline values and the values on day 7 in the survival group （t = -2. 15, P = 0. 045, P 〈 0.05 ）. The differences were also significant between day 5, day 7 and day 3 （ t = - 2. 81, P = 0. 01, t = - 2. 95, P = 0. 01, P 〈0.05 ）. But there were no significant changes in the death group. The ALB level increased along with the duration of hospitalization. Both in the death group and the survival group the BUN differences were significant between the baseline value and that of day 5 ,day 7 （t =2. 39 ,P =0. 02,t =2. 16 P =0. 04,t =2. 19,P =0. 04,P 〈0.05）. In survival group,the values of day 3 differ significantly from day 5, day 7 （ t = - 2. 81, P = 0. 01, t = 2. 35, P = 0. 03, P 〈 0.05 ） , while no significant changes were found in the death group. There was no difference between the two groups when the baseline value was in the normal range （ P 〉 0.05 ） , whereas there was significant difference between the two groups when the baseline value was abnormal （t = 2. 13,P = 0. 046,P 〈 0.05）. [ Conclusion ] Dynamic observation of ALB, Bun may help to predict the clinical prognosis and to guide the treatment.
出处
《大连医科大学学报》
CAS
2009年第6期686-688,共3页
Journal of Dalian Medical University
