山东医药2017，Vol.57Issue(41)：12-15,4.DOI:10.3969/j.issn.1002-266X.2017.41.004
体质量指数对重症急性胰腺炎并ARDS患者治疗效果及预后的影响
Impact of BMI on therapeutic effect and prognosis of patients with severe acute pancreatitis and ARDS
摘要
Abstract
Objective To explore the impact of (BMI)on the therapeutic effect and prognosis of patients with severe acute pancreatitis (SAP)and acute respiratory distress syndrome (ARDS). Methods Totally 106 patients with SAP and ARDS,admitted in the intensive care unit (ICU)with the duration < 24 h were selected. Each patient was treated with standard therapies according to the latest guide of SAP. According to BMI,the patients were divided into BMI normal group (n = 41),overweight group (n = 34),and obese group (n = 31). Acute physiology and chronic health evaluation systemⅡ (APACHE Ⅱ)and acute pancreatitis Rasnon were scored before treatment in the three groups. The white blood cell (WBC),C-reactive protein (CRP),amylase (AMY),urea nitrogen (BUN),creatinine (Cr),blood lactic acid (Lac), and intra-abdominal pressure (IAP),PaO2 / FIO2,PEEP,extravascular lung water index (EVLWI),and pulmonary vas-cular permeability index (PVPI)were measured before and after treatment for 72 h. The volume fluid at 72 h,duration of mechanical ventilation and 28-day mortality were recorded. Results Significant differences were found in the blood WBC, CRP,AMY,BUN,Cr,LAC,IAP,PaO2 / FIO2,PEEP,EVLWI,and PVPI after treatment of 72 h between the control group and BMI normal group (all P < 0. 05). Compared with the obese group,except WBC,CRP,LAC,PaO 2 / FIO2 ,and PEEP,the improvement of the other indexes in the overweight group after treatment of 72 h was statistically significant (all P < 0. 05). Compared with the obese group,the volume fluid at 72 h and the duration of mechanical ventilation were less in the BMI normal and overweight groups,there was statistically significant differences (both P < 0. 05). No significant differ-ence was found in the 28-day mortality between these three groups (P > 0. 05). Binary logistic regression analysis showed that BMI was the prognostic factor for patients with SAP and ARDS. Conclusions BMI may have some influence on the therapeutic effect and prognosis of patients with SAP and ARDS.关键词
胰腺炎,重症急性/急性呼吸窘迫综合征/体质量指数Key words
acute pancreatitis/severe/acute respiratory distress syndrome/body mass index分类
医药卫生引用本文复制引用
王首江,邢柏,谭世峰..体质量指数对重症急性胰腺炎并ARDS患者治疗效果及预后的影响[J].山东医药,2017,57(41):12-15,4.基金项目
海南省卫生计生行业科研立项课题(1601032061A2001). （1601032061A2001）
