摘要
目的 探讨血清白蛋白水平与脓毒症/严重脓毒症/脓毒性休克患儿病情严重程度及预后的关系.方法 观察2008年入住北京儿童医院重症监护病房（ PICU）的所有脓毒症/严重脓毒症/脓毒性休克患儿,在纳入24 h内取外周静脉血检测血清白蛋白,血清白蛋白低于35 g/L为低白蛋白血症诊断标准.结果 共纳入病例247例,低白蛋白血症发生率为72.9％ （180/247）,其中脓毒症组143例,严重脓毒症组65例,脓毒性休克组39例,三组低白蛋白血症发生率分别为59.4％ （85/143）、86.2％（56/65）和100％（39/39）；低白蛋白血症患儿的病死率三组差异有统计学意义（P＜0.001）；存活组低白蛋白血症发生率（69.5％）明显低于死亡组（94.1％）；患儿的危重症病例评分（pediatrics critical illness score,PCIS）与血清白蛋白浓度成正相关（P＜0.001）,病死率与血清白蛋白浓度存在负相关（P＜0.05）.结论 低白蛋白血症在严重脓毒症/脓毒性休克患儿中发病率较高,患儿血清白蛋白水平与预后密切相关,在PCIS评分基础上监测血清白蛋白水平对评估严重脓毒症/脓毒性休克患者预后有重要临床意义.
Objective Sepsis,severe sepsis,and septic shock are frequently encountered and highly lethal conditions among children treated in ICU; however,no many reports on research on serum albumin levels of children under these conditions are available in literature and little is known about the relationship between serum albumin level and prognosis.In this prospective study,the author observed the levels of serum albumin of children with sepsis/severe sepsis/septic shock,and explored the relationship between serum albumin level and severity of illness or prognosis.Method For sepsis/severe sepsis/septic shock patients admitted to the pediatric intensive care unit （PICU） during the year 2008,serum albumin concentration in peripheral blood was examined within 24 h after admission. According to the diagnostic criteria,hypoalbuminemia was defined as serum albumin level of 〈 35 g/L.Result A total of 247 cases of sepsis/severe sepsis/septic shock children were enrolled.In the order of sepsis/severe sepsis/septic shock group,there were 143,65 and 39 cases.Overall rate of hypoalbuminemia was 72.9% （180/247）.The rate of hypoalbuminemia in children with sepsis,severe sepsis or septic shock was 59.4% （ 85/143 ）,86.2%（56/65） and 100% （39/39）,respectively.The mortality of hypoalbuminemic patients in sepsis,severe sepsis and septic shock group showed significant difference （P 〈 0.001 ）.The rates of hypoalbuminemia of the survived cases （69.5 % ）was significantly lower than that of the non-survived cases （94.1% ）.Pediatrics critical illness score （PCIS） and serum albumin concentration was positively correlated （P 〈 0.001 ）,and the mortality was negatively correlated with serum albumin concentration （P 〈 0.05 ）. ConclusionHypoalbuminemia is common among children with sepsis/severe sepsis/septic shock and serum albumin level is closely related to prognosis.Serum albumin level monitoring on the basis of PCIS scoring has important clinical prognostic significance in evaluating the prognosis of severe sepsis/septic shock patients.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2012年第3期184-187,共4页
Chinese Journal of Pediatrics
基金
首都医学发展科研基金：2007-1025
