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儿童严重脓毒症危险因素分析
作者:陈鸿健  周凯  梅小丽 
单位:南京医科大学附属儿童医院 感染科, 江苏 南京 210008
关键词:脓毒症 细胞免疫 肝功能 危险因素 
分类号:R720.597
出版年·卷·期(页码):2018·37·第五期(854-857)
摘要:

目的:分析脓毒症与严重脓毒症患儿的生化和细胞免疫指标,探索严重脓毒症的危险因素,为治疗严重脓毒症提供经验。方法:选择2013年1月1日至2017年5月31日严重脓毒症患儿60例(观察组)和脓毒症患儿110例(对照组),分析严重脓毒症的相关危险因素,包括肝功能、肾功能、电解质和细胞免疫功能。结果:与对照组相比,观察组丙氨酸氨基转移酶(P=0.00)、天门冬氨酸氨基转移酶(P=0.001)、谷氨酰转移酶(P=0.00)、乳酸脱氢酶(P=0.00)、肌酸酶同工酶(P=0.009)、三酰甘油(P=0.018)、肌酐(P=0.00)升高,血钙(P=0.00)、高密度脂蛋白胆固醇(P=0.00)降低,T淋巴细胞减少(P=0.002),B淋巴细胞增多(P=0.003),两组间比较差异均有统计学意义。通过Logistic回归分析发现,丙氨酸氨基转移酶升高(B=0.016,P=0.001)、三酰甘油升高(B=0.944,P=0.003)、低血钙(B=-7.324,P=0.001)、血肌酐升高(B=0.024,P=0.031)、T淋巴细胞减少(B=-0.051,P=0.039)是严重脓毒症发生的危险因素。结论:丙氨酸氨基转移酶升高、三酰甘油升高、低血钙、血肌酐升高、T淋巴细胞减少是严重脓毒症发生的危险因素。

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