实用临床医药杂志2017，Vol.21Issue(13)：56-60,5.DOI:10.7619/jcmp.201713015
成人体外膜肺氧合支持过程中高胆红素血症的发生率、危险因素及结局
Incidence rate, risk factors and outcome of hyperbilirubinemia in adult cardiac patients supported by extracorporeal membrane oxygenation
摘要
Abstract
Objective To explore the incidence rate,risk factors and outcome of hyperbilirubinemia in adult cardiac patients supported by extracorporeal membrane oxygenation(ECMO).Methods Clinical data of 89 adult cardiac patients with ECMO in Fuwai Hospital were retrospectively analyzed.All patients were divided into normal group,high bilirubin group and severe high bilirubin group.In a multiple linear regression analysis,logarithmic transformation was performed for non-normally distributed variables.Results The incidence rate of hyperbilirubinemia was 73％,including 30 cases in high bilirubin group and 35 cases in severe high bilirubin group.A multiple linear regression analysis showed that lg(peak TBIL+1)was significantly associated with lg(peak AST+1)(P=0.001),lg(peak free hemoglobin +1)(P=0.003)and TBIL before ECMO(P=0.009).There was also a linear correlation between peak TBIL and TBIL before ECMO support(P=0.011),peak AST(P=0.004)and peak free hemoglobin during ECMO(P<0.001).The patients in severe high bilirubin group had lower platelets during ECMO,and the survival rate was the lowest.Conclusion Hyperbilirubinemia remains common in patients with ECMO,and is associated with low platelet and a high rate of in-hospital mortality.Hemolysis and liver dysfunction during ECMO support and high bilirubin level before ECMO are risk factors of hyperbilirubinemia.关键词
体外膜肺氧合/高胆红素血症/危险因素Key words
extracorporeal membrane oxygenation/hyperbilirubinemia/risk factors分类
医药卫生引用本文复制引用
吕琳,胡强,姚婧鑫,高国栋,龙村,黑飞龙,吉冰洋,刘晋萍,于坤,胡金晓..成人体外膜肺氧合支持过程中高胆红素血症的发生率、危险因素及结局[J].实用临床医药杂志,2017,21(13):56-60,5.基金项目
首都临床特色应用研究基金(Z111107058811090) （Z111107058811090）
