文章摘要
李青,杨明,田雪.脓毒症病人肠黏膜屏障功能损伤与病情严重程度和预后的相关性研究[J].安徽医药,2022,26(10):2072-2076.
脓毒症病人肠黏膜屏障功能损伤与病情严重程度和预后的相关性研究
Correlation between intestinal mucosal barrier dysfunction, severity and prognosis in septic patients
  
DOI:10.3969/j.issn.1009-6469.2022.10.038
中文关键词: 脓毒症  肠黏膜  胺氧化酶(含铜)  高乳酸血症  脂肪酸结合蛋白质类  预后
英文关键词: Sepsis  Intestinal mucosa  Amine oxidase(copper-containing)  Hyperlactatemia  Fatty acid-binding proteins  Prognosis
基金项目:
作者单位
李青 廊坊市人民医院急诊科河北廊坊065000 
杨明 廊坊市人民医院急诊科河北廊坊065000 
田雪 廊坊市中医院妇产科河北廊坊 065000 
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中文摘要:
      目的研究脓毒症病人肠黏膜屏障功能损伤与病情严重程度和预后的相关性。方法以 2016年 9月至 2019年 9月廊坊市人民医院收治的 126例脓毒症病人为研究对象,包含脓毒症 61例和脓毒症休克 65例;依据重症病人急性胃肠损伤分级(AGI)分为胃肠功能正常 22例, Ⅰ级 20例、 Ⅱ级 35例、 Ⅲ级 43例、 Ⅳ级 6例);依据病人出院结局分为 85例生存组和 41例死亡组。另选同期门诊健康体检者 57例作为对照组。比较各组二胺氧化酶( DAO)、 D-乳酸、肠型脂肪酸结合蛋白( I-FABP)、急性生理学和慢性健康状况评价 Ⅱ(APACHEⅡ)评分、序贯器官衰竭评分( SOFA)和血气指标。结果脓毒症休克组 DAO、D-乳酸、 IFABP、APACHEⅡ、SOFA评分及二氧化碳分压( PaCO2)为( 11.29±1.89)mg/mL、(37.27±4.86)mg/L、(4987.03±682.12)mg/L、
英文摘要:
      Objective To study the correlation between intestinal mucosal barrier dysfunction and severity and prognosis in septic patients.Methods From September 2016 to September 2019, 126 patients with sepsis admitted to the Department of Intensive Medi.cine of Langfang People's Hospital were selected as the research subjects, including 61 patients with sepsis and 65 patients with septicshock. According to the acute gastrointestinal injury classification (AGI) of severe patients, there were 22 cases with normal gastrointes.tinal function, 20 cases with grade I, 35 cases with grade Ⅱ, 43 cases with grade Ⅲ and 6 cases with grade Ⅳ. Another 57 outpatientswere selected as control group. According to the discharge outcome, the patients were divided into 85 survival groups and 41 deathgroups. The diamine oxidase (DAO), D-lactic acid, intestinal fatty acid binding protein (I-FABP), acute physiology and chronic healthstatus (APACHEⅡ), sequential organ failure score (SOFA) and blood gas index were compared in each group.Results In the septic shock group, DAO, D-lactic acid, IFABP, APACHEⅡ, SOFA score and carbon dioxide partial pressure (PaCO2) were (11.29±1.89) mg/mL, (37.27±4.86) mg/L, (4987.03±682.12) mg/L, (25.96±3.28), (13.14±1.85), (51.16±7.44) mmHg, which were higher than those in theseptic group (8.71±0.91) mg/mL, (20.15±3.15) mg/L, (1267.55±158.03) mg/L, (16.31±2.17), (9.25±1.49), (43.10±6.77) mmHg, andhigher than those in the control group (3.08±0.41) mg/mL, (10.29±1.37) mg/L, (861.84±103.29) mg/L, (11.29±1.27), (1.21±0.13),(34.28±4.28) mmHg,the partial pressure of oxygen (PaO2) in septic shock group, which were lower than those in the septic shock group,and lower than those in the control group, the difference were statistically significant (P<0.05). The scores of DAO, D-lactic acid, IF. ABP, APACHEⅡ, SOFA and PCO2 in septic group +AGI Ⅳ were higher than those in septic group +AGI Ⅲ, septic group +AGI Ⅱ, sep. tic group +AGI Ⅰ and septic gastrointestinal function normal group, PaO2 was lower than those in septic group +AGI Ⅲ, septic group +AGI Ⅱ, septic group +AGI Ⅰ and septic gastrointestinal function normal group, the difference was statistically significant (P<0.05). The DAO, D-lactic acid, IFABP, APACHEⅡ, SOFA scores and PCO2 in the death group were higher than those in the survival group, while PaO2 was lower than that in the survival group, the difference was statistically significant (P<0.05). DAO, D-lactic acid, IFABP, APACHE Ⅱ, SOFA score and PCO2 were positively correlated with PaO2in septic patients.Conclusion Impairment of intestinal mucosal barrierfunction in septic patients can increase the mortality of patients. Clinical measurement of intestinal mucosal barrier function can reflectthe severity of patients' illness and predict the prognosis to some extent.
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