| Objective: To investigate the prognostic factors of sepsis and provide clinical evidence for early treatment. Methods: One hundred and fifteen patients with sepsis in the ICU of Chengdu Military General Hospital from March 2012 to May 2015 were studied by retrospective analysis.Indicators such as gender, age, the length of ICU stay, APACHE? score, the rate of ventilator treatment, lactate, platelet counts, central venous oxygen saturation and prognosis were included in the regression model to perform statistics analysis. Results: 1) Respiratory system was the main source of infection in patients with sepsis(54.8%), followed by urinary tract(17.4%),digestive system(13.9%), blood stream(6.1%) and abdominal cavity(4.3%). 2)Of all 115 cases with sepsis in this study, 35 cases died while 80 cases survived in 28 days. The 28-day mortality was 30.4%. In terms of age, OR value and28-day mortality rate increased with age(OR=2.317, 95%CI=1.219-6.475,P=0.023; and OR=3.169, 95%CI=2.423-8.601,P=0.016, respectively). In the perspective of APACHE? score, OR value and 28-day mortality rate increased with APACHE ? score(OR=3.208, 95%CI=1.3763-7.441, P < 0.001,and OR=3.947, 95%CI=1.895-9.367,P=0.04, respectively). In the perspective of lactate, OR value and 28-day mortality rate increased with lactate(OR=1.712,95%CI=1.167-2.511,P=0.012; and OR=2.201, 95%CI=1.486-4.019,P=0.006,respectively). In mechanical ventilation, the higher OR value in patients appliedwith mechanical ventilation, the higher death rate(OR=1.102,95%CI=0.078-4.004,P=0.004). In the use of vasoactive?sedative and analgesic drugs, the higher OR value in patients of those, the higher risk of death(OR=17.072, 95%CI=2.314-125.953, P=0.005;and OR=12.304,95%CI=1.319-114.775,P=0.028, respectively). Conclusions: The risk factors of prognosis in patients with sepsis include age, APACHE ? score, lactate,ventilator therapy, vasoactive drugs, sedative and analgesic drugs.Background: Sepsis is a Systemic Inflammatory Response Syndrome to invasive infections. It has high morbidity and mortality in Intensive Care Unit,which appears as cell damage and microcirculatory disturbance caused by immune disorders. If Sepsis continues to develop, it may lead to severe sepsis and septic shock. Furthermore, there are no good biological indicators for evaluating clinical condition. In recent years, an increasing number of reports pointed out that mitochondrial is injured and its function is inhibited when Sepsis, but the mechanism is not clear. objective:This subject is aim to explore the association between the function of mitochondrial respiratory chain and prognosis of sepsis patient by detecting the activity of respiratory chain enzyme,which provide theoretical and experimental basis for clinical understanding of sepsis. Methods:A total of 30 patients who diagnosed with sepsis in the ICU of Chengdu Military General Hospital from May 2014 to June 2015 were selected for Case-Control study. Patients were divided into death group(12 cases) and improved group(18 cases) according to prognosis. EDTA-anticoagulative venous blood was collected for 1 day, 3 day and 5 day. Platelets mitochondria were isolated from venous blood and the activity of mitochondrial respiratory chain was detected in the Central Laboratory of Chengdu Military General Hospital. Then, the association between the function of mitochondrial respiratory chain and prognosis of sepsis were analyzed.10 casas of healthy were chosen as controls, which platelets mitochondria were isolated and theactivity of mitochondrial respiratory chain were detected as normal reference values. Results: Comparing to the controls, the activity of respiratory chain complex ????? in sepsis group were decreased remarkably(P<0.05).Respiratory chain complex activity tended to gradually decrease in death group,while in improved group, it showed a slightly increasing trend, but still below normal. Conclusion:1.The activities of respiratory chain complex????? are significantly inhibited in sepsis group, and the degree of inhibition is related to severity and prognosis. So, the activity of mitochondrial respiratory chain can be used as biological indicators of sepsis. 2. Although the activities of mitochondrial respiratory chain complexes ?, ?, ?, ? are inhibited in sepsis group, with the evolution of condition,changes between death group and improving group are completely different. The activities of mitochondrial respiratory chain complexes in death group are inhibited markedly when condition exacerbated; while improved group rise slightly when condition improved, but still below normal. |
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