血压变异性对脓毒症患者器官功能障碍的预测价值。

Predictive value of blood pressure variability for organ dysfunction in patients with sepsis.

机构信息

Department of Critical Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.

出版信息

Ann Palliat Med. 2021 Sep;10(9):9678-9684. doi: 10.21037/apm-21-2183.

DOI:10.21037/apm-21-2183

PMID:34628893

Abstract

BACKGROUND

Sepsis is a common disease in the intensive care unit, accompanied by many complications and high mortality. Organ dysfunction is a major risk factor for death in patients with sepsis. Analyzing the related factors of organ dysfunction caused by sepsis can provide more clinical prevention and treatment targets, and better predict patients' prognoses. This study aimed to investigate the relationship between blood pressure variability (BPV) and organ dysfunction in patients with sepsis.

METHODS

One hundred and two patients with sepsis treated in our hospital from January 2019 to January 2021 were retrospectively collected as an observation group, and 102 healthy people were collected as a control group. The 24-hour systolic blood pressure variability (24h SBPV) and 24-hour diastolic blood pressure variability (24h DBPV) of the two groups were compared, and the correlation between 24h SBPV, 24h DBPV, and organ function damage to sepsis patients were analyzed.

RESULTS

Compared with the control group, the 24h DBPV in the observation group was significantly higher (0.56±0.16 vs. 0.37±0.16, P=0.000). 24h SBPV increased significantly (0.56±0.16 vs. 0.36±0.17, P=0.000). Pearson linear correlation analysis showed 24h SBPV was positively correlated with the level of procalcitonin, APACHEII score, and SOFA score (r=0.301, 0.216 and 0.218, P<0.05). 24h DBPV was positively correlated with the level of procalcitonin, APACHEII score, and SOFA score (r=0.302, 0.212 and 0.210, P<0.05). 24h SBPV and 24h DBPV are of certain value in the diagnosis of multiple organ failure in patients with sepsis, and the area under the curve was [0.649 (95% CI: 0.539-0.759), P=0.010] and [0.650 (0.540-0.760), P=0.009], respectively. 24h SBPV and 24h DBPV are of certain value in the diagnosis of persistent organ failure in patients with sepsis, and the area under the curve was [0.647 (95% CI: 0.538-0.757), P=0.010] and [0.647 (95% CI: 0.538-0.757), P=0.010], respectively.

CONCLUSIONS

The increase of BPV in patients with sepsis has a certain value in predicting the prognosis and organ function damage to patients with sepsis.

摘要

背景

脓毒症是重症监护病房常见的疾病，伴有许多并发症和高死亡率。器官功能障碍是脓毒症患者死亡的主要危险因素。分析脓毒症引起的器官功能障碍的相关因素，可以提供更多的临床预防和治疗靶点，更好地预测患者的预后。本研究旨在探讨脓毒症患者血压变异性（BPV）与器官功能障碍的关系。

方法

回顾性收集我院 2019 年 1 月至 2021 年 1 月收治的 102 例脓毒症患者作为观察组，并收集同期 102 例健康人作为对照组。比较两组 24 小时收缩压变异性（24h SBPV）和 24 小时舒张压变异性（24h DBPV），分析 24h SBPV、24h DBPV 与脓毒症患者器官功能损害的相关性。

结果

与对照组相比，观察组 24h DBPV 明显升高（0.56±0.16 vs. 0.37±0.16，P=0.000），24h SBPV 明显升高（0.56±0.16 vs. 0.36±0.17，P=0.000）。Pearson 线性相关分析显示，24h SBPV 与降钙素原、APACHEⅡ评分、SOFA 评分呈正相关（r=0.301、0.216、0.218，P<0.05）。24h DBPV 与降钙素原、APACHEⅡ评分、SOFA 评分呈正相关（r=0.302、0.212、0.210，P<0.05）。24h SBPV 和 24h DBPV 对脓毒症患者多器官衰竭的诊断具有一定价值，曲线下面积分别为[0.649（95%CI：0.539-0.759），P=0.010]和[0.650（95%CI：0.540-0.760），P=0.009]。24h SBPV 和 24h DBPV 对脓毒症患者持续性器官衰竭的诊断具有一定价值，曲线下面积分别为[0.647（95%CI：0.538-0.757），P=0.010]和[0.647（95%CI：0.538-0.757），P=0.010]。