摘要
目的分析重症患者持续性炎症-免疫抑制-分解代谢综合征(persistent inflammation immunosuppression catabolism syndrome,PICS)的临床特征。方法以2014年1月—2020年12月延安市人民医院重症医学科(intensive care unit,ICU)收治的患者200例为研究对象,回顾性收集其临床资料,根据是否并发PICS分为PICS组(n=108)、非PICS组(n=92)。比较两组临床一般资料、T淋巴细胞亚群、血液指标及预后情况。结果PICS组年龄、急性生理学及慢性健康状况评分系统(acute physiology andchronic health evaluation scoring systemⅡ,APACHEⅡ)评分、序贯器官衰竭估计(sequential organ failure assessment,SOFA)评分、消化道穿孔比例高于非PICS组,体质量指数(body mass index,BMI)低于非PICS组(P<0.05)。PICS组CD8^(+)高于非PICS组(P<0.05),PICS组CD3^(+)、CD4^(+)/CD8^(+)、CD4^(+)低于非PICS组(P<0.05)。PICS组前白蛋白(proalbumin,PAB)、淋巴细胞计数低于非PICS组,降钙素原(procalcitonin,PCT)水平高于非PICS组(P<0.05)。PICS组ICU内获得性感染的发生率、死亡率高于死亡,住ICU时间长于非PICS组(P<0.05)。结论ICU内重症患者并发PICS较为常见,患者存在T淋巴细胞亚群及血液指标异常,继发感染风险高,预后较差,临床可针对性采取干预措施。
Objective To analyze the clinical features of severe patients with persistent inflammation immunosuppres⁃sion catabolism syndrome(PICS).Methods From January 2014 to December 2020,200 patients admitted to the Depart⁃ment of critical care medicine in our hospital were selected as the research objects,and their clinical data were collect⁃ed retrospectively.According to whether they were complicated with PICS,they were divided into the PICS group(n=108)and the non PICS group(n=92).The clinical data,T lymphocyte subsets,blood indexes and prognosis of the two groups were compared.Results The age,APACHEⅡscore,SOFA score and the proportion of gastrointestinal perfora⁃tion in the PICS group were higher than those in the non PICS group,and BMI was lower than that in the non PICS group(P<0.05).CD8^(+)in the PICS group was higher than that in the non PICS group(P<0.05),and CD3^(+),CD4^(+)/CD8^(+),CD4^(+)in the PICS group were lower than those in the non PICS group(P<0.05).PAB and lymphocyte count in the PICS group were lower than those in the non PICS group,and PCT level was higher than that in the non PICS group(P<0.05).The incidence and mortality of acquired infection in ICU of the PICS group were higher than those of death,and the length of stay in ICU of the PICS group was longer than that of the non PICS group(P<0.05).Conclusion PICS is more common in ICU patients with severe illness.Patients with abnormal T lymphocyte subsets and blood indexes have high risk of secondary infection and poor prognosis,and targeted intervention measures can be taken in clinic.
作者
杨蓉
杜玲玲
章志丹
白英杰
YANG Rong;DU Lingling;ZHANG Zhidan;BAI Yingjie(Yan'an People's Hospital,Yan'an Shanxi 716000,China)
出处
《中国急救复苏与灾害医学杂志》
2021年第8期919-921,共3页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
陕西省科协企业创新争先青年人才托举计划项目(编号:20190306)。
