ICU脓毒症患者血清丙二醛、超氧化物歧化酶水平及SOFA评分与预后的关系-现代医学

ICU脓毒症患者血清丙二醛、超氧化物歧化酶水平及SOFA评分与预后的关系

单位：1. 自贡市第一人民医院重症医学科, 四川自贡 643000;
2. 自贡市第一人民医院神经内科, 四川自贡 643000

分类号：R459.7

出版年·卷·期（页码）：2020·48·第十期（1325-1328）

摘要：

目的：探究ICU脓毒症患者血清丙二醛（MDA）、超氧化物歧化酶（SOD）水平及序贯器官衰竭估计（SOFA）评分与预后的关系，为ICU脓毒症患者预后的早期预测提供临床参考价值。方法：选取我院2017年8月至2018年8月收治的91例ICU脓毒症患者，按照入院后30 d生存情况分为生存组（70例）和死亡组（21例）。比较两组患者入院时MDA、SOD水平及SOFA评分差异，运用受试者工作特征（ROC）曲线评价上述指标单独预测、联合预测ICU脓毒症患者预后的临床价值。结果：死亡组MDA水平与SOFA评分均高于生存组，而SOD水平低于生存组，差异均有统计学意义（P<0.05）。Pearson相关分析显示，SOFA评分与MDA呈正相关（r=0.712，P<0.001），与SOD呈负相关（r=-0.737，P<0.001）。ROC曲线显示，SOFA评分联合MDA、SOD水平的曲线下面积（AUC）大于各指标单项分析。结论：ICU脓毒症患者MDA、SOD水平存在明显异常，入院时SOFA评分联合MDA、SOD水平可预测重症脓毒症的死亡风险，对ICU脓毒症预后的预测具有重要意义，值得临床参考。

Objective: To investigate the relationships between serum malondialdehyde(MDA), superoxide dismutase(SOD) levels, sequential organ failure assessment(SOFA) scores and prognosis in ICU patients with sepsis, and provide some early prediction clinical references for ICU patients with sepsis.Methods: 91 patients with sepsis in ICU from August 2017 to August 2018 were selected and divided into survival group(70 cases) and death group(21cases) according to the 30 days survival station after admission. The differences of serum MDA, SOD levels and SOFA scores were compared between the two groups. The clinical value of these indicators in predicting the prognosis of ICU sepsis patients was evaluated by receiver operating characteristic(ROC) curve. Results: MDA level and SOFA score of death group were higher than those of survival group, but SOD level of death groupwas lower than that of survival group(P<0.05). Pearson correlation analysis showed that SOFA score was positively correlated with MDA(r=0.712,P<0.001)and negatively correlated with SOD(r=-0.737,P<0.001).ROC curve showed that the area under the curve(AUC) of SOFA score combined with MDA and SOD levels was significantly higher than that of each index alone. Conclusion: The serum levels of MDAand SOD are abnormal in ICU patients with sepsis. SOFA score combined with MDA and SOD levels on admission can predict the death risk of severe sepsis, and itis of great significance in predicting the prognosis of patients with sepsis in ICU, and itis worthy of clinical reference.

参考文献：

[1] 盛博,陈炜,甄洁,等.入院时APACHEⅡ评分、SOFA评分及ALB水平对严重脓毒症患者预后结局的影响[J].热带医学杂志,2017,17(12):1648-1651.
[2] MASSON S,CAIRONI P,FANIZZA C,et al.Sequential N-terminal pro-B-Type natriuretic peptide and high-sensitivity cardiac troponin measurements during albumin replacement in patients with severe sepsis or septic shock[J].Crit Care Med,2016,44(4):707-716.
[3] 赖剑波,姚志军,李健球,等.脓毒症患者肌钙蛋白Ⅰ与血清一氧化氮、丙二醛及超氧化物歧化酶的关系及意义[J].广东医学,2011,32(17):2265-2267.
[4] 中华医学会重症医学分会.中国严重脓毒症/脓毒性休克治疗指南(2014)[J].中华内科杂志,2015,54(6):557-581.
[5] WANG H,ZHANG Z,HUANG W.Surviving sepsis campaign:international guidelines for management of sepsis and septic shock(2016):interpretation and expectation[J].Chin J Crit Care & Intensive Care Med,2017,3(1):26-32.
[6] MURIOVÁ K,MALÁSKA J,OTEVREL F,et al.Myocardial dysfunction in sepsis——definition and pathogenetic mechanisms[J].Vnitr Lek,2010,56(3):220-225.
[7] 刘晨燕,柴艳芬.脓毒症患者左心室功能改变及其临床意义探讨[J].中外医疗,2010,29(9):19-21.
[8] SAIKI R,PARK H,ISHII I,et al.Brain infarction correlates more closely with acrolein than with reactive oxygen species[J].Biochem Biophys Res Commun,2011,404(4):1044-1049.
[9] SCHERBAKOV N,EBNER N,SANDEK A,et al.Influence of essential amino acids on muscle mass and muscle strength in patients with cerebral stroke during early rehabilitation:protocol and rationale of a randomized clinical trial(AMINO-Stroke Study)[J].BMC Neurology,2016,22(16):10-16.
[10] DELLINGER R P,LEVY M M,RHODES A,et al.Surviving Sepsis Campaign:international guidelines for management of severe sepsis and septic shock,2012[J].Intensive Care Med,2013,39(2):165-228.
[11] VIASUS D,GARCIA-VIDAL C,SIMONETTI A,et al.Prognostic value of serum albumin levels in hospitalized adults with community acquired pneumonia[J].J Infect,2013,66(5):415-423.
[12] 董宏艳,刘先华,周智勇,等.降钙素原和APACH Ⅱ评分对老年脓毒症患者病情判断及预后评估的研究[J].实用老年医学,2015,29(6):457-460.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录