本文選題：膿毒癥 + 膽堿酯酶��； 參考：《廣東醫(yī)學(xué)》2017年06期

【摘要】：目的探討老年嚴(yán)重膿毒癥患者早期血清膽堿酯酶(S-Ch E)、過(guò)氧化脂質(zhì)(LPO)的變化及意義。方法以193例嚴(yán)重膿毒癥患者為觀察組,以同期住院的膿毒癥患者235例為對(duì)照組;根據(jù)治療14 d的預(yù)后將觀察組分為死亡組(n=104)與生存組(n=89);觀察患者早期血清S-Ch E和LPO水平及變化情況;繪制受試者工作特征(ROC)曲線,分析血清S-Ch E和LPO水平與老年膿毒癥MODS預(yù)后的關(guān)系。結(jié)果觀察組血清S-Ch E低于對(duì)照組、LPO水平高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);死亡組首次及治療1、3 d的血清S-Ch E低于存活組、LPO水平高于存活組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);觀察組中低S-Ch E者死亡風(fēng)險(xiǎn)高于非低S-Ch E者,差異有統(tǒng)計(jì)學(xué)意義(P0.05);高LPO者死亡風(fēng)險(xiǎn)高于非高LPO者,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。血清SCh E、LPO水平預(yù)測(cè)嚴(yán)重膿毒癥死亡危險(xiǎn)性的ROC曲線面積分別為0.912、0.828,敏感度分別為0.793、0.924,特異度分別為0.914、0.638,兩者聯(lián)合檢測(cè)嚴(yán)重膿毒癥死亡危險(xiǎn)性的敏感度0.806,特異度0.935。結(jié)論 S-Ch E和LPO水平變化與嚴(yán)重膿毒癥預(yù)后有關(guān),兩者聯(lián)合應(yīng)用有助于預(yù)測(cè)老年嚴(yán)重膿毒癥死亡危險(xiǎn)性。
[Abstract]:Objective to investigate the changes and significance of serum cholinesterase S-Ch EO and lipid peroxide (LPO) in elderly patients with severe sepsis. Methods 193 patients with severe sepsis were used as observation group and 235 patients with sepsis in the same period as control group. According to the prognosis of 14 days after treatment, the observation group was divided into two groups: the death group (n = 104) and the survival group (n = 89); the levels and changes of serum S-Ch E and LPO in the early stage of the patients were observed; To analyze the relationship between serum S-Ch E and LPO levels and MODS prognosis in elderly sepsis. Results the level of serum S-Ch E in the observation group was lower than that in the control group, the difference was statistically significant (P 0.05), and the level of serum S-Ch E in the death group was lower than that in the survival group at the first and third day after treatment, which was higher than that in the survival group. The risk of death in low S-Ch E group was higher than that in non low S-Ch E group (P 0 05), and the death risk in high LPO group was higher than that in non high LPO group (P 0 05). The area of ROC curve, the sensitivity and the specificity of the ROC curve for predicting the death risk of severe sepsis were 0.912 ~ 0.828 and 0.914 ~ 0.638, respectively. The sensitivity and specificity of the two methods were 0.806 and 0.935 respectively. Conclusion the changes of S-Ch E and LPO levels are related to the prognosis of severe sepsis.
【作者單位】： 華北理工大學(xué)附屬醫(yī)院重癥醫(yī)學(xué)科;
【基金】：河北省醫(yī)學(xué)科學(xué)研究重點(diǎn)課題(編號(hào):ZL20140238)
【分類號(hào)】：R459.7

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