摘要
目的探讨血清白蛋白水平对评估脓毒症患儿疾病严重程度及预后的作用。方法回顾性分析2010年2月至7月入住重症监护病房的212例脓毒症患儿的临床资料,其中严重脓毒症52例,脓毒性休克31例,另选择同期住院非脓毒症患儿110例作为对照组;观察低蛋白血症与小儿危重症评分(PCIS)、小儿死亡危险因素(PRISMⅢ)、预后的关系,以及不同严重程度脓毒症患儿白蛋白水平的变化,分析白蛋白≤25 g/L的相关因素。结果随着血清白蛋白水平下降,PCIS呈下降趋势,而PRISMⅢ呈上升趋势,差异均有统计学意义(P<0.01)。脓毒性休克、严重脓毒症、脓毒症患儿及对照组的血清白蛋白水平的差异有统计学意义(F=13.938,P=0.000)。单因素分析显示,白蛋白水平≤25 g/L的脓毒症患儿受累器官衰竭数更多,病死率更高,住院时间和住PICU时间更长,更可能需呼吸机支持,差异均有统计学意义(P均<0.01)。脓毒症患儿的血清白蛋白水平越低,治愈率和好转率越低,病死率越高(r s=–0.161,P=0.000)。结论低蛋白血症可作为反映脓毒症患儿疾病严重程度的间接指标;白蛋白≤25 g/L预示脓毒症患儿疾病严重、预后差。
Objective To discuss the significance of serum albumin level in assessing severity, progress and prognosis of sepsis in children. Methods The clinical data of 212 patients diagnosed with sepsis admitted to PICU from February 2010 to July 2010 were retrospectively analyzed, and 52 patients had severe sepsis and 31 patients had septic shock. Meanwhile, 110 non-sepsis patients were selected as controls. The relationships of hypoalbuminemia with pediatric critical illness score （PCIS）, pediatric risk of mortality III （PRISM Ⅲ） and prognosis were evaluated, and the change of albumin level in patients with dif- ferent severity of sepsis was observed. Relative factors analysis of albumin level ≤25 g/L was performed. Results As the serum albumin level was decreased, the PCIS was significantly decreased while the PRISM Ⅲ was increased （P〈0.01）. The se- rum albumin level was significantly different among children with septic shock, severe sepsis and sepsis and controls （F=13.938, P=O.O00）. The results of relative factors analysis showed that sepsis children with an albumin level〈25 g/L had more organ failures, higher mortality, longer hospital and PICU stay and more likelihood for ventilator support （P〈0.01）. Lower albumin levels were accompanied with lower rates of recovery and improvement but higher mortality （rs=-0.161, P=O.O00）. Conclusions Hypoalbuminemia can be used as indirect indicator for severity of infection. The albumin level 〈25 g/L indicated the severity of illness and prognosis in children with sepsis.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2013年第10期941-945,共5页
Journal of Clinical Pediatrics
