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目的观察血清白蛋白水平(ALB)对严重脓毒症患儿预后的临床意义。方法将82例严重脓毒症患儿根据预后情况分为存活组(54例)和死亡组(28例)。在确诊为严重脓毒症时及确诊后的第1、3、5、7天检测2组血清ALB。于确诊为严重脓毒症时比较2组血清降钙素原(PCT)、超敏C反应蛋白(Hs-CRP)、白细胞计数(WBC)和急性生理学及慢性健康状况评分(APACHEⅡ评分);运用Pearson相关性分析血清ALB与PCT、Hs-CRP、WBC和APACHEⅡ评分相关性。结果死亡组血清ALB在确诊为严重脓毒症时及确诊后的第1、3、5、7天一直维持较低水平,存活组血清ALB上升,且死亡组均低于存活组(P<0.01);确诊为严重脓毒症时死亡组血清PCT、Hs-CRP、WBC和APACHEⅡ评分均高于存活组(P<0.01);经过Pearson相关分析表明确诊为严重脓毒症时血清ALB与PCT、Hs-CRP、WBC和APACHEⅡ评分均呈负相关(P<0.01)。结论血清ALB值可作为严重脓毒症患儿预后判断指标,为后期临床治疗提供依据。
Objective To observe the clinical significance of serum albumin (ALB) in the prognosis of children with severe sepsis. Methods 82 cases of severe sepsis were divided into survival group (54 cases) and death group (28 cases) according to the prognosis. Two groups of serum ALB were detected on the 1st, 3rd, 5th and 7th day after the diagnosis of severe sepsis. Serum procalcitonin (PCT), Hs-CRP, WBC and APACHEⅡ scores were compared between the two groups in the diagnosis of severe sepsis. Pearson correlation analysis of serum ALB and PCT, Hs-CRP, WBC and APACHE II score correlation. Results Serum ALB in the death group remained at a low level on the 1st, 3rd, 5th and 7th days after diagnosis of severe sepsis and serum albumin level increased in the surviving group, and death group was lower than that in the surviving group (P <0.01) ). The serum PCT, Hs-CRP, WBC and APACHEⅡ scores in the death group were higher than those in the surviving group (P <0.01) after the diagnosis of severe sepsis. Pearson correlation analysis showed that serum ALB and PCT, Hs-CRP, WBC and APACHE Ⅱ scores were negatively correlated (P <0.01). Conclusion Serum ALB can be used as a prognostic indicator in children with severe sepsis and provide the basis for clinical treatment.