论文部分内容阅读
目的：分析脓毒症相关性脑病（ SAE）的临床特征及危险因素。方法收集2010年1月至2014年12月来首都医科大学附属北京友谊医院接受脓毒症治疗的215例患者的临床资料，回顾性分析患者的基本情况、实验室检查指标，分析导致SAE的危险因素。结果 SAE的发生率为55．81％（120／215）， SAE组病死率显著高于非SAE组[28．33％（34／120）比7．39％（7／95），P＜0．05]，两组急性生理学与慢性健康状况评分Ⅱ（APACHEⅡ）差异有统计学意义（P＜0．05）。 SAE组丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、总胆红素及动脉血二氧化碳分压（PaCO2）显著高于非SAE组[（90±8） U／L比（49±9） U／L，（144±7） U／L比（67±9） U／L，（20．3±5．1）μmol／L比（19．2±4．2）μmol／L，（43±13） mmHg（1 mmHg＝0．133 kPa）比（37±14） mmHg]，白蛋白显著低于非SAE组[（29±5） g／L比（31±6）g／L]（P＜0．05），Logistic回归分析结果显示，ALT（OR＝5．117，95％CI 1．255～20．863）、白蛋白（OR＝6．509，95％CI 3．351～12．643）、PaCO2（OR＝5．828，95％CI 2．563～13．252）、APACHEⅡ评分（OR＝5．375，95％CI 2．774～10．415）是SAE发生的危险因素。结论 SAE患者的病死率显著高于非SAE患者，APACHEⅡ评分、ALT、白蛋白、PaCO2对SAE的预后有重要意义。“,”Objective To analyze the clinical features of sepsis associated encephalopathy ( SAE) and risk factors. Methods The data of patients who had septic encephalopathy in Beijing Friendship Hospital ,Capital Medical University from Jan.2010 to Dec.2014 were collected and analyzed retrospectively .Retrospective analysis of the basic conditions of patients,laboratory tests and the risk factors of SAE was done .Results The incidence of SAE was 55.81%(120/215), mortality rate of the SAE group was 28.33%(34/120),of the non-SAE group was 7.39%(7/95),the difference was statis-tically significant(P<0.05);acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score,alanine aminotrans-ferase( ALT) ,aspartate acid aminotransferase and carbon dioxide partial pressure ( PaCO2 ) of SAE group were higher than those of non-SAE group[(90 ±8) U/L vs (49 ±9) U/L,(144 ±7) U/L vs (67 ±9) U/L,(20.3 ±5.1) μmol/L vs (19.2 ±4.2) μmol/L,(43 ±13) mmHg vs (37 ±14) mmHg],serum albumin was lower than that in non-SAE group [(29 ±5) g/L vs (31 ±6)g/L](P<0.05);Logistic regression analysis showed that,ALT(OR=5.117,95%CI 1.255-20.863),serum albumin(OR=6.509,95%CI 3.351-12.643),PaCO2(OR=5.828,95%CI 2.563-13.252),APACHEⅡscore( OR=5.375 ,95%CI 2.774-10.415 ) were serious risk factors for SAE .Conclusion The mortality of SAE patient was significantly higher than the non-SAE patients.APACHEⅡscore,ALT,albumin,PaCO2 have great significances for the prognosis of SAE .