Sato T, Wada Y, Okazaki M, Kobayashi S, Okabe N, Eto Y, Kubo M, Maekawa K
Department of Pediatrics, kashiwa Hospital, Jikei University School of Medicine.
Kansenshogaku Zasshi. 1996 Aug;70(8):784-91. doi: 10.11150/kansenshogakuzasshi1970.70.784.
Underlying diseases, complications, clinical findings, and laboratory findings were evaluated in 158 cases of septicaemia admitted to Jikei University Hospital from 1975 to 1994, in order to conjectured factors that prescribe for the prognosis. 50% of the patients had underlying diseases. Malignancy including leukaemia (31 cases, 39.2%) was the most common underlying disease, followed by low birth weight infant (17 cases, 21.5%), aplastic anemia (9 case, 11.4%), and congenital heart disease (7 cases, 8.9%). The death rate for patients with underlying disease (27.8%) was significantly greater than the mortality for normal patients with septicaemia (8.9%) (p < 0.05). Meningitis (24.7%) was the most common complication, followed by DIC (19.6%), shock (15.2%), and pneumonia (10.8%). The mortality rate of septicaemia complicated by shock was 66.7% (p < 0.01), and that complicated by DIC was 45.2% (p < 0.01). The mortality rate for patients with the clinical findings of respiratory distress, cough, abdominal distention, cyanosis, splenomegaly, or peripheral coldness was more than 40% and significantly greater (p < 0.01). Mortality rate in patients with granulocyte counts of < 4.000/mm3, platelet counts of < 5 x 10(4)/ mm3, total protein of < 5.0 g/dl, or ESR of < 20 mm/hr were significantly greater (p < 0.01) than those in patients with normal laboratory findings. Coincidence rate of blood and stool cultures was 57.9% for E. coli, and 28.6% for Klebsiella sp., and that of blood and throat cultures was more than 30% for Pseudomonas sp., Haemophilus influenzae, and Staphylococcus aureus. In the study of antimicrobial susceptibility for microorganisms isolated, the number of drug resistant S. aureus had increased in the last 10 years.
对1975年至1994年期间入住庆应义塾大学医院的158例败血症患者的基础疾病、并发症、临床症状和实验室检查结果进行了评估，以推测影响预后的因素。50%的患者患有基础疾病。包括白血病在内的恶性肿瘤（31例，39.2%）是最常见的基础疾病，其次是低体重儿（17例，21.5%）、再生障碍性贫血（9例，11.4%）和先天性心脏病（7例，8.9%）。患有基础疾病的患者死亡率（27.8%）显著高于无基础疾病的败血症患者死亡率（8.9%）（p<0.05）。脑膜炎（24.7%）是最常见的并发症，其次是弥散性血管内凝血（DIC）（19.6%）、休克（15.2%）和肺炎（10.8%）。并发休克的败血症患者死亡率为66.7%（p<0.01），并发DIC的患者死亡率为45.2%（p<0.01）。有呼吸窘迫、咳嗽、腹胀、发绀、脾肿大或四肢发冷等临床症状的患者死亡率超过40%，且显著更高（p<0.01）。粒细胞计数<4000/mm³、血小板计数<5×10⁴/mm³、总蛋白<5.0g/dl或血沉<20mm/hr的患者死亡率显著高于实验室检查结果正常的患者（p<0.01）。大肠杆菌血培养与便培养的符合率为57.9%，克雷伯菌属为28.6%，铜绿假单胞菌、流感嗜血杆菌和金黄色葡萄球菌血培养与咽培养的符合率均超过30%。在对分离出的微生物进行抗菌药敏研究中，耐药金黄色葡萄球菌的数量在过去10年中有所增加。
