不同致病菌所致脓毒症患者低磷血症的临床研究.docVIP

不同致病菌所致脓毒症患者低磷血症的临床研究 　　【摘要】目的 比较脓毒症组与非脓毒症组患者，并将脓毒症组进行亚组分析，探讨低磷血症的影响因素。方法 按年份分层随机抽取脓毒症组患者312例与非脓毒症组患者300例，脓毒症组患者中革兰阴性菌（G-菌）感染170例，革兰阳性菌（G+菌）感染142例，均包括4种不同细菌的感染。收集、整理各组患者的血磷值，比较各组间的低血磷发生率、平均血磷浓度和相对危险度（RR）。结果 脓毒症组与非脓毒症组比较，低血磷发生率差异具有统计学意义（P1.2；G-菌感染组与G+菌感染组比较、4种G+菌感染组间比较，低血磷发生率和平均血磷水平均差异具有统计学意义（P1.2；4种G-菌感染组间比较，低血磷发生率和平均血磷水平均差异无统计学意义（P0.05），RR1.2。结论 脓毒症是发生低磷血症的危险因素，尤其是本研究中的4种G-菌以及G+菌中的金黄色葡萄球菌和肠球菌感染，在临床工作中我们应警惕脓毒症患者血磷水平的变化，预防发生严重并发症。 　　【关键词】低磷血症；脓毒症；革兰阴性菌；革兰阳性菌 　　A clinical study of sepsis patients with hypophosphatemia infected by different bacteria Zhang Xiaoli* ，Qu Yan， Huang Jianbo. * Qingdao University，Qingdao，266071，China 　　Corresponding author： Qu Yan， Email： qdquyan@ 　　【Abstract】Objective The aim of this study was to compare hypophosphatemia between the sepsis patients and the non-sepsis patients， and between within the subgroups of sepsis patients.Methods We collected 312 sepsis cases and 300 non-sepsis cases by stratified random sampling method yearly. In the sepsis cases， the number infected by gram-negative bacteria was 170， and by gram-positive bacteria was 142， containing 4 different bacteria infected cases in each one. Serum phosphorus of cases in each group were collected. The data were statistically processed to compare the incidence rates of hypophosphatemia， mean serum phosphorus levels and relative risk among groups. Results There was a statistical difference between the sepsis cases and the non-sepsis cases in incidence rate of hypophosphatemia （P1.2）. There were statistical differences between the cases infected by gram-negative bacteria and the cases infected by the gram-positive bacteria， also among cases infected by 4 different gram-positive bacteria in both incidence rate of hypophosphatemia and average serum phosphorus level （all P 1.2.There were no statistical differences among cases infected by 4 different gram-negative bacteria in both incidence rate of hypophosphatemia and average serum phosphorus level （both P 0.05）， and RR 1.2.