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时间:2020-05-12
《肥胖对严重脓毒症患者预后的影响.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、·911·论著肥胖对严重脓毒症患者预后的影响戴凌燕,庄荣【摘要】目的探讨肥胖与严重脓毒症患者预后的关系。方法选取2010年1月—2014年2月于温州医科大学附属第二医院治疗的严重脓毒症患者363例为研究对象,依据体质指数(BMI)将患者分为体质量过轻组(36例)、体质量正常组(160例)和超重及肥胖组(167例);另根据预后将患者分为生存组(287例)和死亡组(76例)。收集患者一般资料,以急性生理与慢性健康状况评分系统Ⅱ(APACHEII)进行评价,记录入院时降钙素原(PCT)、乳酸水平,脓毒性休克发生率及转归情况。结果糖尿病、慢性阻塞性肺疾病(COP
2、D)检出率随体质量增加而升高(x2:6.482、6.667,P3、.53,95%(0.31,0.94),P=0.02]、PCT[=0.095,OR=1.10,95%C/(1.08,1.16),P=0.02]、孚L酸[卢=0.095,OR=1.10,95%C,(1.08,1.16),P<0.01]、APACHEII评分[=0.122,OR=1.13,95%C/(1.10,1.18),P<0.O1]、脓毒性休克[=一0.186,OR=0.83,95%c,(O.61,1.14),P=0.02]进入回归方程。结论肥胖可能是严重脓毒症患者预后的潜在保护因素,其作用的机制可能与胰岛素抵抗相关。【关键词】脓毒症;肥胖症;预后;瘦素【4、中图分类号】R631【文献标识码】Adoi:10.3969/j.issn.1007—9572.2015.08.013戴凌燕,庄荣.肥胖对严重脓毒症患者预后的影响[J].中国全科医学,2015,18(8):911—914.[www.chinagp.net]DaiLY,ZhuangR.Impactofobesi~onprognosisofseveresepsis[J].ChineseGeneralPractice,2015,18(8):91】一914.ImpactofObesityonPrognostsofSevereSep~sDAILing—yan,ZHU5、ANGRong.DepartmentofIntensweCareUnit,theSecondAfiliatedHospitalofWenzhouMedicalUnive~ity,Wenzhou325007,China【Abstract】ObjectiveToexploretheimpactofobesityontheprognosisofseveresepsispatients.MethodsAtotalof363patientswithseveresepsistreatedintheSecondAffiliatedHospitalofWenzhouMe6、dicalUnivemityfromJanuary2010toFebruary2014weredivided,accordingtoBMI,intogroupsA(whoseweightweretoolight,n=36),B(whoseweightwerenormal,n=160),C(whowereoverweightandobese,/7,=167),andaccordingtoprognosis,intogroupssurvival(n=287),death(n:76).rI'hepatientsgeneraldatawerecollecteda7、ndevaluatedbyAPACHEⅡ,andthelevelsofprocalcitonin(PCT),lacticacid(LA),theincidenceofsepticshock(ss)anditsturnoverwererecorded.ResultsThedetectionratesofdiabetes,COPDrosewiththeincreaseofbodyweight(xd=6.482,6.667,P<0.05).Theage,PCT,LA,APACHEⅡscores,incidenceofSSwerehigherindeathgro8、upthaninsurvivalgroup(t=4.710,3.030,5.54
3、.53,95%(0.31,0.94),P=0.02]、PCT[=0.095,OR=1.10,95%C/(1.08,1.16),P=0.02]、孚L酸[卢=0.095,OR=1.10,95%C,(1.08,1.16),P<0.01]、APACHEII评分[=0.122,OR=1.13,95%C/(1.10,1.18),P<0.O1]、脓毒性休克[=一0.186,OR=0.83,95%c,(O.61,1.14),P=0.02]进入回归方程。结论肥胖可能是严重脓毒症患者预后的潜在保护因素,其作用的机制可能与胰岛素抵抗相关。【关键词】脓毒症;肥胖症;预后;瘦素【
4、中图分类号】R631【文献标识码】Adoi:10.3969/j.issn.1007—9572.2015.08.013戴凌燕,庄荣.肥胖对严重脓毒症患者预后的影响[J].中国全科医学,2015,18(8):911—914.[www.chinagp.net]DaiLY,ZhuangR.Impactofobesi~onprognosisofseveresepsis[J].ChineseGeneralPractice,2015,18(8):91】一914.ImpactofObesityonPrognostsofSevereSep~sDAILing—yan,ZHU
5、ANGRong.DepartmentofIntensweCareUnit,theSecondAfiliatedHospitalofWenzhouMedicalUnive~ity,Wenzhou325007,China【Abstract】ObjectiveToexploretheimpactofobesityontheprognosisofseveresepsispatients.MethodsAtotalof363patientswithseveresepsistreatedintheSecondAffiliatedHospitalofWenzhouMe
6、dicalUnivemityfromJanuary2010toFebruary2014weredivided,accordingtoBMI,intogroupsA(whoseweightweretoolight,n=36),B(whoseweightwerenormal,n=160),C(whowereoverweightandobese,/7,=167),andaccordingtoprognosis,intogroupssurvival(n=287),death(n:76).rI'hepatientsgeneraldatawerecollecteda
7、ndevaluatedbyAPACHEⅡ,andthelevelsofprocalcitonin(PCT),lacticacid(LA),theincidenceofsepticshock(ss)anditsturnoverwererecorded.ResultsThedetectionratesofdiabetes,COPDrosewiththeincreaseofbodyweight(xd=6.482,6.667,P<0.05).Theage,PCT,LA,APACHEⅡscores,incidenceofSSwerehigherindeathgro
8、upthaninsurvivalgroup(t=4.710,3.030,5.54
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