本文選題：膿毒癥 + 左心室舒張功能障礙�。� 參考：《山東醫(yī)藥》2017年06期

【摘要】：目的觀察膿毒癥患者二尖瓣舒張?jiān)缙诜辶魉倥c二尖瓣環(huán)舒張?jiān)缙谶\(yùn)動(dòng)速度比值(E/e')的變化,探討其對(duì)膿毒癥預(yù)后的評(píng)估價(jià)值。方法將82例膿毒癥患者根據(jù)住院28 d內(nèi)是否存活分為存活組59例和死亡組23例。分別于入ICU第1、3、7天行經(jīng)胸壁超聲心動(dòng)圖檢查,應(yīng)用組織多普勒成像(DTI)技術(shù)測(cè)定E/e'。應(yīng)用多因素Logistic回歸分析E/e'與膿毒癥患者28 d病死率的相關(guān)性,利用受試者工作者特征曲線(ROC)分析E/e'對(duì)膿毒癥患者28 d病死率的預(yù)測(cè)價(jià)值。結(jié)果死亡組E/e'入ICU第3、7天均高于第1天(P均0.05),第3天與第7天比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。存活組E/e'入ICU第3天高于第1天(P0.05);第7天較第3天降低(P0.05),與第1天比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。死亡組E/e'在第1、3、7天均較存活組明顯增高(P均0.05)。Logistic回歸分析顯示,E/e'與膿毒癥患者28 d病死率顯著相關(guān)(P0.05),ROC分析顯示,E/e'第1、3、7天評(píng)估膿毒癥患者28 d病死率的曲線下面積分別為0.72、0.84、0.80,以第3天的E/e'值11.3為截點(diǎn)值,其預(yù)測(cè)28d病死率的敏感度為73.9%、特異度為72.9%。結(jié)論 E/e'是膿毒癥患者28 d死亡的獨(dú)立預(yù)測(cè)指標(biāo),有助于評(píng)估膿毒癥患者的預(yù)后。
[Abstract]:Objective to observe the changes of mitral peak velocity and mitral annular early diastolic velocity ratio (E / E) in patients with sepsis and to evaluate the prognosis of sepsis. Methods Eighty-two patients with sepsis were divided into survival group (59 cases) and death group (23 cases) according to whether they survived in hospital for 28 days. Transthoracic echocardiography and tissue Doppler imaging (DTI) were performed on the 1st and 7th day after admission to ICU. Multivariate logistic regression analysis was used to analyze the correlation between Er / e' and fatality rate in sepsis patients at 28 days. The predictive value of Er / e' for 28 days mortality of sepsis patients was analyzed by means of roc. Results in the death group, the mean value of E / E'in ICU on the 3rd day was higher than that on the first day (P < 0.05), but there was no significant difference between the third day and the seventh day. In the survival group, the level of E / E'in ICU on the 3rd day was higher than that on the first day, and on the 7th day it was lower than that on the third day, but there was no significant difference between the survival group and the first day. In death group, E / E 'was significantly higher than that in survival group on day 1 and 3 (P < 0.05). Logistic regression analysis showed that there was a significant correlation between E / E' and mortality rate in sepsis patients at 28 days (P < 0.05). ROC analysis showed that E / E'on the 1st day of death was significantly higher than that in survival group (P < 0.05). Take the E / P 'value of 11.3 on the 3rd day as the cut-off point. The sensitivity and specificity in predicting the fatality rate of 28 days were 73.9 and 72.9 respectively. Conclusion Er\ -e' is an independent predictor of 28 days death in sepsis patients, which is helpful to evaluate the prognosis of sepsis patients.
【作者單位】： 承德醫(yī)學(xué)院附屬醫(yī)院;
【基金】：河北省科技支撐計(jì)劃項(xiàng)目(152777205)
【分類號(hào)】：R459.7

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