危重症患者血清胱抑素C与预后关系临床研究.docVIP

危重症患者血清胱抑素C与预后关系临床研究 　　[摘要] 目的 探讨急诊危重病患者血清胱抑素C(Cys C)浓度的改变与预后的关系。方法 测定119例入住ICU的危重病患者血清Cys C浓度,并对危重病患者进行急性生理学和慢性健康状况评分Ⅱ(APACHEⅡ)评分;分析血清Cys C浓度与预后的关系。结果 存活组Cys C浓度与死亡组Cys C浓度比较差异有统计学意义。存活组APACHEⅡ评分与死亡组APACHEⅡ评分的比较差异有统计学意义。APACHEⅡ评分与Cys C浓度呈正相关性。结论 观察Cys C浓度和APACHEⅡ评分,对危重病患者判断病情及预后有一定作用。 　　[关键词] 危重病;血清胱抑素C;预后 　　[中图分类号] R459.7[文献标识码] A[文章编号] 1673-9701(2010)14-10-02 　　 　　Relationship between Serum Cys C Level and Prognosis in ICU Patients 　　ZHANG Yumei 　　Department of Emergency,Guilin Municipal Hospital of Integrated Traditional and Western Medicine,Guilin 541004,China 　　 　　[Abstract] Objective To study the relationship between the serum Cys C level and the prognosis of patients admitted to intensive care unit(ICU). Methods The serum Cys C Level was measured in 119 ICU cases,and the relationship between acute physiology and chronic health evaluationⅡ(APACHEⅡ) score,Cys C level and prognosis were analyzed. Results The Cys C level in the survival group was significantly lower than that in the dead group. The APACHEⅡ score in the survival group was significantly lower than that in the dead group. The higher the serum Cys C level was,the higher the APACHEⅡ score and the mortality were. Conclusion The relationship between serum Cys C level and APACHEⅡ plays an important role in judgment of the condition and prognosis of patients admitted to ICU. 　　[Key words] Critical disease;Serum Cys C;Prognosis 　　危重病发生时体内环境发生严重改变,血液Cys C浓度亦可能会发生改变。Cys C是一类小分子蛋白质,在体内有核细胞产生,其浓度不受多种肾外因素的干扰,产生速率恒定,而且只通过肾小球滤过率排泄,具备作为肾小球滤过率理想标志物的条件,是近年来报道的反映肾小球滤过率的理想的内源性指标[1]。急性生理学和慢性健康状况评分Ⅱ(APACHEⅡ)自1985年Knaus创立以来,广泛用于评定危重病患者病情的严重程度及预后。本研究以ICU内危重病患者为研究对象,研究患者Cys C及APACHEⅡ评??与预后的关系。 　　1资料与方法 　　1.1研究对象 　　2009年1～12月入住我院ICU的119例患者,其中入ICU未满9h死亡及资料不完整的病例被剔除。根据入住ICU 20d后死亡与生存分为存活组(78例)、死亡组(41例)。存活组男46例,女性32例,年龄30～85岁,平均(52.4±16.3)岁。其中心血管疾病15例,呼吸系统疾病16例,脑血管意外9例,多发伤性创伤13例,脓毒症14例,心肺复苏术后11例。死亡组男23例,女性18例;年龄34～88岁,平均(53.5±17.1)岁。其中心血管疾病6例,呼吸系统疾病8例,脑血管意外5例,多发性创伤7例,脓毒症6例,心肺复苏术后9例。存活组与死亡组性别、年龄及病种上比较差异无统计学意义(P0