本文選題：膿毒癥 + 肌鈣蛋白�。� 參考：《河北醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的:應(yīng)用meta分析的方法研究肌鈣蛋白升高與膿毒癥患者死亡率的關(guān)系,探討肌鈣蛋白對(duì)膿毒癥患者預(yù)后的預(yù)測價(jià)值。方法:檢索PUBMED,EMBASE,OVID,MEDLINE,Cochrane Library,萬方數(shù)據(jù)庫,中國知網(wǎng)數(shù)據(jù)庫,中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫,維普數(shù)據(jù)庫,全面搜索2001年1月至2015年12月的臨床研究,根據(jù)納入及排除標(biāo)準(zhǔn)進(jìn)行篩選,納入合格的臨床研究,進(jìn)行質(zhì)量評(píng)價(jià)及數(shù)據(jù)提取,應(yīng)用Revman5.3軟件進(jìn)行meta分析,評(píng)價(jià)膿毒癥患者肌鈣蛋白水平與病死率、住院時(shí)間等指標(biāo)的關(guān)系,統(tǒng)計(jì)結(jié)果用森林圖表示,通過漏斗圖檢驗(yàn)發(fā)表偏倚。結(jié)果:研究共納入13項(xiàng)獨(dú)立研究,2754例患者參與研究。Meta分析結(jié)果顯示,與肌鈣蛋白正常組膿毒癥患者相比:1)肌鈣蛋白升高組患者入院APACHEⅡ評(píng)分明顯升高(MD=3.43,95%CI:2.42-4.44,Z=6.65,P0.01);2)肌鈣蛋白升高組患者住院期間血管活性藥物的使用率明顯增加(RR=1.27,95%CI:1.11-1.44,Z=3.53,P=0.0004);3)肌鈣蛋白升高組患者住院期間CRRT的使用率增加(OR=3.38,95%CI:1.37-8.37),Z=2.64,P=0.008);4)肌鈣蛋白升高組患者的住院時(shí)間顯著延長(MD=5.75,95%CI:3.24-8.26,Z=4.49,P0.01);5)肌鈣蛋白升高對(duì)膿毒癥患者住院期間機(jī)械通氣的使用率無明顯影響(RR=1.12,95%CI:1.01-1.23,Z=2.24,P=0.03);6)肌鈣蛋白升高組患者的死亡率明顯增加(RR=2.09,95%CI:1.78-2.44,Z=8.05,P0.01)結(jié)論:肌鈣蛋白升高的膿毒癥患者入院APACHEⅡ評(píng)分升高、住院期間血管活性藥物及CRRT的使用率增加,患者的平均住院時(shí)間延長,與肌鈣蛋白正常的膿毒癥患者相比有更高的病死率。肌鈣蛋白升高對(duì)膿毒癥患者的病情嚴(yán)重程度及預(yù)后有預(yù)測價(jià)值。
[Abstract]:Objective: to study the relationship between the elevation of troponin and the mortality rate of septic patients by meta analysis, and to explore the prognostic value of troponin in sepsis patients. Methods: search PUBMED EMBASE OVIDM MEDLINE Cochrane Library, Wanfang Database, China knowledge Network Database, Chinese Biomedical Literature Database, Weip Database, search the clinical research from January 2001 to December 2015, and screen according to the inclusion and exclusion criteria. Quality evaluation and data extraction were carried out in qualified clinical studies, and meta analysis was carried out with Revman5.3 software to evaluate the relationship between cardiac troponin level and mortality, hospital stay, etc. The statistical results were expressed by forest map. Publication bias is checked by funnel graph. Results: a total of 2754 patients in 13 independent studies were included in the study. Meta-analysis showed that, Compared with sepsis patients with normal troponin group, the APACHE 鈪，

本文編號(hào)：1838903