摘要
目的探讨脓毒症相关性脑病患者舌下微循环变化特点及微循环障碍在脓毒症相关性脑病发病中的作用。方法选取49例脓毒症患者分为非脓毒症相关性脑病组(23例)和脓毒症相关性脑病组(26例),应用旁流暗视野技术观察两组患者舌下微循环指标,同时监测两组患者的血流动力学指标及病死率进行分析。结果与脓毒症组患者相比,脓毒症相关性脑病组患者舌下微循环障碍明显,总血管密度TVD(6.11±2.19mm/mm2vs 8.51±2.11mm/mm2,P=0.000,r=-0.513),灌注血管密度PVD(7.23±3.09mm/mm2vs 9.94±2.17mm/mm2,P=0.010,r=-0.505),灌注血管比例PPV(47.48%±20.60%vs 81.46%±7.45%,P=0.000,r=-0.737),两组患者微血管流动指数无明显差别MFI(1.45±0.71 vs 1.89±0.85,P=0.054,r=-0.277);两组患者第28天病死率有明显差别(38.46%vs 13.04%,P=0.044,P<0.05)。结论脓毒症相关性脑病患者舌下微循环障碍明显,其在脓毒症相关性脑病发病机制中具有重要作用。
Objective To investigate the sublingual microcirculation feature of patients with sepsis - associated encephalopathy （SAE） and weather microcirculation dysfunction play a role in mechanism of SAE. Methods Totally 49 septic patients were divided into SAE group （n = 26 ） and non - SAE group （ n = 23 ） , Sublingual microcirculation parameters were observed by sidestream dark - field （SDF） imaging and parameters of microcirculation perfusion variations, hemodynamic parameters and prognoses were analyzed. Results Compared with septic patients, sublingual microcirculation of patients with SAE was impaired dramatically. There was significant decrease in total perfused density TVD （ 6.11 ± 2.19mm/mm2 vs 8.51 ±2.11 mm/mm2 , P = 0. 000, r = - 0.513 ）, perfused vessel density （ PVD ） （ 7.23 ± 3.09mm/mm2 vs 9.94 ± 2.17mm/mm2 , P = 0.010, r = - 0. 505 ） and proportion of perfused vessels （ PPV ） （ 47.48 % ±20.60% vs81.46% ±7.45% ,P=0.000,r=0.737） inSAE group. Microvascular flow index （MFI）（1.45 ±0.71 vs 1.89 ±0.85,P=0.054, r = -0. 277）showed no obvious difference（P 〉 0.05 ）. Mortality of two groups over a 28 day period was 38.46% vs 13.04% , and the difference was significant （ P 〈 0.05 ） between two groups. Conclusion Sublingual microcirculation dysfunction is a feature of patients with SAE and maintain a important cause of SAE.
出处
《医学研究杂志》
2014年第10期49-52,共4页
Journal of Medical Research
基金
首都医学发展基金资助项目(SF-2009-Ⅱ-14)
关键词
脓毒症相关性脑病
脓毒症
舌下微循环
Sepsis - associated encephalopathy
Sepsis
Sublingual microcirculation
