摘要
目的探讨血浆中性粒细胞明胶蛋白酶相关脂质运载蛋白(NGAL)水平对严重脓毒症患者死亡和多器官功能障碍综合征(MODS)的预测价值。方法选取2017年1月~2019年1月收治的60例脓毒症患者作为实验组,按照病情不同严重程度分为实验1组(脓毒症)与实验2组(严重脓毒症),同期选取60例入住ICU非脓毒症患者作为对照组,观察实验组与对照组的临床基本特征,且评估实验1组与实验2组的NGAL、PCT、乳酸、APACHEⅡ评分、BNP、死亡率及多器官功能障碍综合征发生率。结果实验组的年龄、白蛋白、血小板、白细胞、MAP及肾代替治疗所占比例与对照组比较,差异无统计学意义(P>0.05);实验组ScvO2、CVP、PaO2/FiO2、机械通气、凝血酶原时间与对照组比较,差异有统计学意义(P<0.05)。实验2组NGAL、PCT、乳酸、APACHEⅡ评分、BNP均高于实验1组,差异有统计学意义(P<0.05)。实验2组死亡率及多器官功能障碍综合征发生率均高于实验1组,差异有统计学意义(P<0.05)。结论血浆中性粒细胞明胶蛋白酶相关脂质运载蛋白是临床诊断脓毒症的特异性指标之一,该指标水平的上升能够增加多器官功能障碍综合征发生率及死亡率,即可直接反映病情严重程度及评估预后效果。
Objective To investigate the predictive value of plasma neutrophil gelatinase-related lipid delivery protein(NGAL)levels in patients with severe sepsis and multiple organ dysfunction syndrome(MODS).Methods 60 patients with sepsis admitted to ICU from January 2017 to January 2019 were selected as the experimental group.According to the severity of their condition,they were divided into experimental group 1(sepsis)and experimental group 2(severe sepsis).At the same time,another 60 patients who admitted to ICU without sepsis were selected as the control group.The clinical basic characteristics of the experimental group and control group were observed,and NGAL,PCT,lactic acid,APACHE Ⅱ score,the BNP,mortality and the incidence of multiple organ dysfunction syndrome of experiment 1 and experiment 2 group were evaluated.Results The proportion of age,albumin,platelet,leukocyte,MAP and renal replacement in the experimental group were not statistically significant compared with those in the control group(P>0.05).Compared with the control group,the time of ScvO2,CVP,PaO2/FiO2,mechanical ventilation and prothrombin in the experimental group were statistically significant(P<0.05).NGAL,PCT,lactic acid,APACHE Ⅱ score,BNP in experimental 2 group were higher than those in experimental group 1,the difference was statistically significant(P<0.05).The mortality rate and the incidence of multi-organ dysfunction syndrome in the experimental group 2 were higher than that in experimental group 1,with statistically significant difference(P<0.05).Conclusion Plasma neutrophil gelatinaserelated lipid transporter protein is one of the specific indicators for clinical diagnosis of sepsis.The increase in the level of this indicator can increase the incidence and mortality of multi-organ dysfunction syndrome,which can directly reflect the severity of the disease and evaluate the prognosis.
作者
王佳
胡晓宁
孟文格
刘红娟
耿静
郎哲
WANG Jia;HU Xiaoning;MENG Wen'ge;LIU Hongjuan;GENG Jing;LANG Zhe(Emergency Department of the First Affiliated Hospital of Hebei North University,Hebei,Zhangjiakou 075000,China;Department of Intensive Care,Shijiazhuang First Hospital,Hebei,Shijiazhuang 050000,China)
出处
《中国医药科学》
2020年第3期22-25,共4页
China Medicine And Pharmacy
基金
河北省石家庄市科学技术研究与发展计划项目(151461343)。
