中国循证儿科杂志2011，Vol.6Issue(5)：376-380,5.DOI:10.3969/j.issn.1673-5501.2011.05.012
脓毒症患儿血清白蛋白水平与预后的相关性分析
The correlation analysis of serum albumin levels and prognosis in children with sepsis
范江花 1肖政辉 1祝益民 1胥志跃 1隆彩霞1
作者信息
- 1. 湖南省儿童医院重症监护一科,长沙,410007
- 折叠
摘要
Abstract
Objective To explore the association between hypoalbuminemia and the severity and prognosis of sepsis in children.Methods Children diagnosed as sepsis in PICU in Hunan Provincial Children s Hospital from February to July 2010 were retrospectively collected.Clinical manifestation.laboratory examination index, related parameters of disease severity and prognosis were extracted.According to albumin levels within 24 h admission into PICU, the patients were divided into severe hypoalbuminemia group ( ≤25 g · L-1 ), moderate hypoalbuminemia group ( -30 g · L-1 ), mild hypoalbuminemia group ( - 35 g · L-1 ) and normal albumin group ( ＞ 35 g · L-1 ).The correlation of albumin levels with clinical manifestations.laboratory index and relevant outcome were analyzed.The relevance of albumin levels and the prognosis was analyzed by Logistic regression.Results A total of 212 cases meeting with sepsis criteria were analyzed, including 24 cases in severe hypoalbuminemia group, 50 in moderate hypoalbuminemia group, 61 in mild hypoalbuminemia group and 77 in normal albumin group.① The incidences of diarrhea.abdominal distension, bowel sound weakened, stress ulcer.edema and MODS ＞ 3 in severe hypoalbuminemia group were significantly elevated ( P ＜0.05 ).②With the serum albumin levels decreasing , the incidences of WBC count, CRP≥8 mg · L-1 and PCT ＞2 mg · L-1 , glucose≥6.7 mmol · L-1 and lactate levels were increased( P ＜ 0.05 ).With the serum albumin levels decreasing, PRISM Ⅲ , the incidences of severe sepsis and septic shock were significantly elevated, while PICS was declined ( P ＜0.05 ).④Logistic regression analysis showed that PRISM Ⅲ≥8, severe sepsis and septic shock.severe hypoalbuminemia were death risk factors in children with sepsis , OR( 95％ CI ) was 8.20( 1.325 - 18.96 ).2.85( 1.34 - 10.73 )and 1.22( 1.02 -15.78 ) respectively.⑤The albumin levels in survival group 1, 3 and 7 days after admission were significantly higher than the death or abandon group in the corresponding period, and there were significant differences.conclusions Hypoalbuminemia can be used as an indirect inflammatory infection indicator to reflect the degree of severe infection.The albumin level≤25 g · L-1 can he used as the death risk factors in children with sepsis.关键词
脓毒症/低白蛋白血症/预后/儿童Key words
Sepsis / Hypoalbuminemia/ Prognosis / Children引用本文复制引用
范江花,肖政辉,祝益民,胥志跃,隆彩霞..脓毒症患儿血清白蛋白水平与预后的相关性分析[J].中国循证儿科杂志,2011,6(5):376-380,5.
