[1]沈丽娟a,孙 杰a,吴 晓b,等.老年脓毒症患者血清清蛋白水平与其危重程度及预后的相关性[J].现代检验医学杂志,2017,32(01):131-133,137.[doi:10.3969/j.issn.1671-7414.2017.01.036]
　SHEN Li-juana,SUN Jiea,WU Xiaob,et al.Relationship of Albumin Levels with the Prognosis and Severity of Illness among Elderly Sepsis Patients[J].Journal of Modern Laboratory Medicine,2017,32(01):131-133,137.[doi:10.3969/j.issn.1671-7414.2017.01.036]
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老年脓毒症患者血清清蛋白水平与其危重程度及预后的相关性()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第32卷
期数:
2017年01期
页码:
131-133,137
栏目:
检验与临床
出版日期:
2017-01-25

文章信息/Info

Title:
Relationship of Albumin Levels with the Prognosis and Severity of Illness among Elderly Sepsis Patients
文章编号:
1671-7414(2017)01-131-04
作者:
沈丽娟a; 孙 杰a; 吴 晓b; 于修文a; 黄 崴a; 王 莉b; 王 飞b
上海市嘉定区中心医院a.检验科;
b.急诊科,上海 201800
Author(s):
SHEN Li-juana; SUN Jiea; WU Xiaob; YU Xiu-wena; HANG Weia; WANG Lib;  WANG Feib
a.Department of Clinical Laboratory;
b.Department of Emergency, Central Hospital of Jiading District,Shanghai 201800,China
关键词:
脓毒症;  清蛋白;  严重程度;  预后;  老年
分类号:
R515; R446.112
DOI:
10.3969/j.issn.1671-7414.2017.01.036
文献标志码:
A
摘要:
目的 探讨老年脓毒症患者血清清蛋白水平(ALB)与疾病的危重程度及预后的相关性。方法 回顾性分析2014年10月～2015年12月入住上海市嘉定区中心医院重症监护室的老年脓毒症患者108例,依据28天转归,分为存活组(83例)和死亡组(25例),比较两组之间的一般资料及实验室差异性; 再根据ALB水平分为清蛋白正常组(≥35 g/L,24例),轻度低清蛋白血症组(28 g/L≤ALB＜35 g/L,52例)和重度低清蛋白血症组(＜28 g/L,32例),比较各组间病死率; 并采用Spearman相关分析对ALB与各相关因素进行相关分析。结果 108例老年脓毒症患者28天病死率为23.1%,低蛋白血症发生率为77.8%; 相对于存活组,死亡组的ALB水平[31.7(28.3～35.7)% vs 25.8(21.7～31.8)g/L,P＜0.001]及Hb水平[128(110～140)g/L vs 102(84～132)g/L,P=0.015]显著降低,而昏迷发生率[7(8.4%)vs 13(52.0%),P＜0.001],APACHE II评分[20(18～23)vs 22(19～24),P=0.015]及SOFA评分[6(5～6)vs 6(6～7),P＜0.001]均显著增高; 病死率随着ALB水平的增高显著降低(43.8% vs 21.2% vs 0%,P＜0.05); Spearman相关分析显示ALB与APACHEⅡ评分(r=-0.190,P=0.049)及昏迷(r=-0.311,P=0.001)呈负相关,与Hb(r=0.449,P＜0.001)呈正相关。结论 低蛋白血症在老年脓毒症患者中发生率高,其与病情的危重程度及预后关系密切。
Abstract:
Objective To investigate the relationship of albumin levels with the prognosis and severity of illness in elderly sepsis patients.Methods This was aretrospective study.108 elderly sepsis patients were enrolled from October 2014 to December 2015.All patients were divided into survivors group(83 cases)and death group(25 cases)based on the 28-day prognosis.The differences of clinical data and laboratory were compared between two groups.According to the albumin levels,all patients were divided into three groups,normal albumin group(≥35 g/L,24 cases),and mild hypoproteinemia group(28 g/L≤ALB＜35 g/L,52 cases)and severe hypoproteinemia group(＜28 g/L,32 cases),respectively.The mortality rate was compared in the groups.Spearman Correlation Coefficient was used to analyze ALB and other factors.Results In all 108 patients,the 28-day mortality rate was 23.1%,and 77.8% of the patients with hypoproteinemia.ALB level [31.7(28.3～35.7)g/L vs 25.8(21.7～31.8)g/L,P＜0.001] and Hb [128(110～140)g/L vs 102(84～132)g/L,P=0.015] in death group were significant lowerthan that in survival group.Meanwhile,APACHE II scores [20(18～23)vs 22(19～24),P=0.015] and SOFA score [6(5～6)vs 6(6～7),P＜0.001] were higher than that in survival group.The mortality decreased with the increaseof ALB level(43.8% vs 21.2% vs 0%,P＜0.05).ALB had a negative correlation with APACHEⅡ score(r=-0.190,P=0.049)and coma(r=-0.311,P=0.001),and had a positive correlation with Hb(r=0.449,P＜0.001).Conclusion The incidence of hypoproteinemia was high in elderlysepsis patients. ALB level was associated with prognosis and severity of illness among the patients.

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备注/Memo

备注/Memo:
基金项目:上海市嘉定区卫生局重大项目基金(2013-KY-01); 上海市嘉定区卫生系统第三批重点学科建设项目基金(ZD01); 上海市嘉定区中心医院第十一批中青年骨干培养计划项目基金(2013)。
作者简介:沈丽娟(1986-),女,本科,检验师,研究方向:临床医学检验; Tel:13524448525; E-mail:doctor_sunnie@163.com。
通讯作者:王 飞(1982-),男,硕士,主治医师,研究方向:急重症医学; Tel:13761745257; E-mail:chazwf@163.com
更新日期/Last Update: 2017-01-20