脓毒症患者死亡危险因素分析.docVIP

脓毒症患者死亡危险因素分析 　　[摘要] 目的 探讨脓毒症患者预后的相关因素及脓毒症患者死亡的危险因素。 方法 调查分析152例脓毒症患者临床资料及预后，进行多因素Logistic分析和ROC曲线分析。 结果 152例患者死亡率为30.26%，死亡患者脓毒性休克最多，下呼吸道是最主要的原发感染部位，革兰阴性菌感染最多。年龄、APACHEⅡ、急性肾功能衰竭、MODS、合并慢性病、意识障碍、平均动脉压、血肌酐、血糖及电解质紊乱是影响患者死亡的相关因素。脓毒性休克、严重脓毒症、急性肾功能衰竭、MODS、APACHEⅡ、年龄、血肌酐均为患者死亡的独立危险因素。APACHEⅡ、年龄、血肌酐评价预后的ROC曲线下面积分别为0.793、0.689、0.657均有统计学意义（P 0.05）。 结论 脓毒症死亡率高，随病情严重程度加剧升高，APACHEⅡ、年龄、血肌酐可作为预测患者预后的指标。 　　[关键词] 脓毒症；严重脓毒症；脓毒性休克；死亡；危险因?? 　　[中图分类号] R631 [文献标识码] B [文章编号] 1673—9701（2012）24—0035—03 　　Analysis of risk factors for death of patients with sepsis 　　ZHANG Heying 　　Department of Emergency， Peoples Hospital of Zhuji City in Zhejiang Province， Zhuji 311800， China 　　[Abstract] Objective To investigate the prognosis of patients with sepsis and sepsis patients the risk factors of death. Methods The survey analysis of 152 cases of sepsis with clinical data and prognosis， studied by multivariate Logistic analysis and ROC curve analysis. Results The death rate of 152 cases was 30.26%， and most with septic shock， lower respiratory tract infection and gram—negative bacterial infections. Age， APACHE Ⅱ， acute renal failure， MODS， the merger of chronic diseases， disturbance of consciousness， mean arterial pressure， serum creatinine， glucose， and electrolyte imbalance were the relevant factors death. Septic shock， severe sepsis， acute renal failure， MODS， APACHE II， age， serum creatinine were independent risk factors for death. APACHE II， age， serum creatinine evaluation of prognosis of the area under ROC curve were 0.793， 0.689， 0.657， and were statistically significant （P 0.05）. Conclusion Sepsis mortality is high， exacerbated by increased with the severity of the disease， APACHE II， age， serum creatinine could be used as indicators to predict patient prognosis. 　　[Key words] Sepsis； Severe sepsis； Septic shock； Death； Risk factors 　　脓毒症是感染引起的严重全身性炎症反应，随着病情的恶化可发展为严重脓毒症或脓毒性休克，死亡率约25%～50%，是临床棘手的急危重症。脓毒症还可并发多器官功能障碍综合征（multiple organ dysfunction syndrome，MODS）是导致脓毒症患者死亡的主要原因之一。为进一步了解脓毒症