中国全科医学2018，Vol.21Issue(20)：2420-2425,6.DOI:10.12114/j.issn.1007-9572.2018.00.091
脓毒症心功能障碍患者预后影响因素分析
Factors Associated with the Prognosis of Sepsis-induced Myocardial Dysfunction
摘要
Abstract
Objective To explore the factors associated with the prognosis of patients with sepsis-induced myocardial dysfunction (SIMD).Methods We enrolled 87 patients with sepsis or septic shock complicating SIMD from the Emergency Resuscitation Room and EICU,the First Affiliated Hospital of Xinjiang Medical University from August 2015 to August 2017.We collected their clinical data,laboratory findings and results of echocardiogram.In accordance with the outcome within 28 days after the definite diagnosis of sepsis,we divided them into death group (56 cases) and survival group (31 cases).Multivariate Cox proportional hazards regression was used to explore the associated factors for the prognosis of SIMD.Survival analysis was conducted using Kaplan-meier method.Log-rank test was used to compare the survival rate between the groups.Results Multivariate Cox proportional hazards regression analysis showed that age 〔HR=1.011,95%CI(1.001,1.022)〕,mean arterial pressure (MAP)〔HR=0.985,95%CI(0.975,0.996)〕,heart rate 〔HR=1.012,95%CI(1.004,1.021)〕,NT-proBNP 〔HR=1.010, 95%CI(1.009,1.023)〕,arrhythmia 〔HR=1.875,95%CI(1.415,2.686)〕 were independent factors associated with the prognosis of SIMD patients (P<0.05).Log-rank test revealed that age equal to or less than 65 years old (χ2=4.973, P=0.027),MAP greater than 65 mm Hg (χ2=8.040,P=0.005),heart rate equal to or less than 104 beats/min (χ2=10.725, P=0.001),and NT-proBNP equal to or less than 1 972 μg/L (χ2=11.426,P=0.001),and without or with arrhythmia (χ2=6.524, P=0.011) were associated with higher survival rate.Conclusion Age greater than 65 years old,heart rate greater than 104 beats/min,and NT-proBNP greater than 1 972 μg/L,arrhythmia are independent risk factors while MAP greater than 65 mm Hg is a protective factor associated with the prognosis of SIMD patients.PCT and other inflammatory factors showed no association with the prognosis of SIMD patients.关键词
脓毒症/休克,脓毒性/心室功能障碍/预后Key words
Sepsis/Shock,septic/Ventricular dysfunction/Prognosis分类
医药卫生引用本文复制引用
杨建中,周贤惠,芦颜美,张玲,汤宝鹏..脓毒症心功能障碍患者预后影响因素分析[J].中国全科医学,2018,21(20):2420-2425,6.基金项目
国家一三五重点研发项目-精准医学研究项目(2016YFC0900905) （2016YFC0900905）
国家自然科学基金资助项目(81570297) （81570297）
