摘要
目的探讨血浆皮质醇(COR)水平和重症患者预后的关系。方法采用前瞻性研究方法,对入住重症监护病房(ICU)的患者进行血浆COR检测,收集相关临床指标并观察其28 d预后,所有指标均为患者入科24 h内数值,计算患者转入ICU时的急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)和序贯器官衰竭(SOFA)评分。按不同COR水平分组,比较各组间平均的COR水平、入科24 h内APACHEⅡ评分及28 d的病死率;按预后分为存活组和死亡组,比较其年龄、COR水平APACHEⅡ评分、应激期的一般生命体征等相关指标。结果共纳入重症患者100例,按COR水平分组间进行比较,其平均COR水平、APACHEⅡ评分、28 d病死率差异均有统计学意义(P<0.05),且随COR水平升高,APACHEⅡ评分逐渐升高,28 d病死率有逐渐增高的趋势;与存活组(76例)比较,死亡组(24例)患者COR水平、APACHEⅡ评分、SOFA评分、心率、呼吸频率(RR)及血清Na+差异有统计学意义(P<0.05),COR水平、SOFA评分及RR进入了回归方程。结论入科24 h内COR水平可预测重症患者的预后。
Objective To investigate the relationship between the plasma cortisol and the prognosis of critical patients.Methods A prospective study was conducted.Cortisol monitoring was performed for the adult patients admitting in intensive care unit（ICU） between April 2012 to August 2012.Clinical information was collected and observed the prognosis for 28 days.All the data was obtained within 24 hours.Acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ） and Sequential Organ Failure Assessment（SOFA） scores were evaluated when transferred into ICU.Patients were divided into three groups based on the COR,mean of COR,APACHEⅡscore and 28-day mortality were compared among groups.Patients were divided into survival and non-survival group,and the age,gender and clinical Information was compared.Results Total 100 cases were enrolled.Compared between groups which according to COR levels,its average COR,APACHE Ⅱ score,28 d fatality rate were statistically significant difference（P 0.05）,and with COR level was increased,the APACHE Ⅱ score was increased,28 d case fatality rate has a tendency to increased gradually.Compared with survival group（n = 76）,in non-survival group（n = 24）,the level of COR,APACHEⅡscore,SOFA score,heart rate（HR）,respiratory rate（RR） and Na ＋ had the difference of statistics（P 0.05）.The level of COR,SOFA score and R were entered into the Logistic regression model.Conclusion This study shows that the level of plasma COR within 24 hours has prognostic value for critical patients.
出处
《宁夏医学杂志》
CAS
2013年第7期592-594,共3页
Ningxia Medical Journal
关键词
重症患者
皮质醇
预后
Critical patients
Cortisol
Prognosis
