摘要
目的:分析脓毒症患者同型半胱氨酸的水平与病情严重程度、凝血功能、病情预后及中医证型之间的关系。方法:选取脓毒症患者60例,在诊断为脓毒症后4 h内进行同型半胱氨酸、血栓弹力图的检测,同时对患者病情进行序贯器官衰竭估计评分,治疗28 d后统计患者的死亡情况、多脏器功能衰竭发生情况、休克发生情况、中医证型分布情况。结果:(1)发生休克、多脏器功能衰竭及28 d内死亡的脓毒症患者组血清同型半胱氨酸水平比未发生休克、多脏器功能衰竭及28 d内存活的脓毒症患者组明显升高;(2)相关性分析提示血清同型半胱氨酸水平越高,入科时序贯器官衰竭估计评分越高,28 d内死亡的风险越高;(3)单变量Logistic回归分析结果显示,血清同型半胱氨酸水平对脓毒症患者28 d死亡情况有明显的影响;(4)通过比较中医证型,发现急性虚证组的同型半胱氨酸及28 d病死率最高,其次是血瘀证组及毒热证组。结论:脓毒症患者血清同型半胱氨酸水平对病情严重性及预后的评估有一定的临床应用价值。
Objective:To analyze the relationship between the level of homocysteine in sepsis patients and the severity of the disease,coagulation function,prognosis of the disease and TCM syndrome types.Methods:60 patients with sepsis were selected.Within 4 hours after the diagnosis of sepsis,homocysteine and thromboelastic graph were detected,and SOFA score was performed on the patients’condition.After 28 days of treatment,the death of the patients,the occurrence of multi-organ failure,the occurrence of shock,and the distribution of TCM syndromes were counted.Results:The serum homocysteine level of sepsis patients with shock,multi-organ failure and death within 28 days was significantly higher than that of sepsis patients without shock,multi-organ failure and survival within 28 days.Correlation analysis suggested that the higher the serum homocysteine level,the higher SOFA score,the higher the risk of death within 28 days;univariate Logistic regression analysis showed that serum homocysteine level had a significant influence on 28 days death of sepsis patients.Through the comparison of homocysteine and 28 days death in TCM syndromes,it was found that the acute deficiency syndrome group had the highest death rate of homocysteine and 28 days death,followed by the blood stasis syndrome group and the toxic heat syndrome group.Conclusion:Serum homocysteine levels in patients with sepsis have a certain clinical application value for the evaluation of the severity and prognosis of the disease.
出处
《中医临床研究》
2021年第34期73-75,共3页
Clinical Journal Of Chinese Medicine
基金
福州市市级科技计划项目(2019-S-82),项目名称:基于“热毒血瘀”理论探讨同型半胱氨酸对脓毒症患者预后的评估价值
作者简介
陈伟(1977-),硕士,副主任医师。
