| Objective:To discuss the characteristics of colloid osmotic pressure change in severe sepsis/septic shock,and whether the colloid osmotic pressure can use as a new indicators to evaluate the severity with sepsis patients..Methods:This research adopts the case retrospective studies. All cases were di vided into three parts:the first part is the control group(Group ?) including 50 random check-up crowd in kun Ming medical university medical center form 2014.12—2015.12, collected inspectors basic information, blood routine indexes (including white blood cells, hemoglobin, red blood cells deposited, albumin an d globulin),blood biochemistry indexes(including Albumin, globulin, cereal trans aminase, aspertate aminotransferase, creatinine and urea nitrogen).The second pa rts including 50 patients with severe sepsis(Group ?), the third parts including 56 patients with septic shock (Group ?);the patients of ? group and ?grou p were all from hospitalization patients in the first affiliated hospital of kunMi ng medical university during 2014.12—2015.12. Collected APACHE ? score within first 24 hours (Acute physiology And Chronic Health Evaluation ?), S OFA score (Sepsis relate outraged failure assessment), inflammation index (C-re active protein and procalcitonin), ICU time, prognosis (death or survival), bloo d routine indexes(including white blood cells, hemoglobin, red blood cells depo sited, albumin and globulin),blood biochemistry indexes(including albumin, glob ulin, cereal third transaminase, aspertate aminotransferase, creatinine and urea ni trogen).Plasma colloid osmotic pressure according to the following formula to c alculate:COP(mmHg)=3A+0.2A2+0.01A3+2G+0.2G2+0.01G3;Formula of A repres entative albumin, the unit is g/dl, g represents the globulin, the unit is g/dl. T hree parts to a database of data after finishing in Excel, use SPSS 19.0 statistic al software to analyze data. All measurement data are expressed as x±s, Com pares the single factor analysis of variance between groups, use Spearman corr elation analysis COP and CRP and PCT, Lac, APACHE ? score and the corre lation between the SOFA score, and calculating the correlation coefficient r, P <0.05 that was statistically significant., ROC curve is used to test the COP fo r sepsis/septic shock illness severity value..Results:1.There no statistically significant difference with age and gender com position in patients of three group, P> 0.05; the ratio of infection between ? group and ? group also have no statistically significant difference.2.Comp ared with ? group, the index of COP,|HCT-ALB|, ALB and GLO within 24 hours among of ?,? groups had significant reduced,P<0.05; compared wit h I group and ? groups, the GLO of II group had elevated; compared with II group, the index of COP,ALB and GLO with 24 h of ? group were significa ntly reduced, P<0.05.3.Compared with II group, others indexes of ? group su ch as blood lactate acid(Lac), APACHE II score and SOFA score had signific antly elevated, P<0.05.4.Compared with live patients, the COP level of 24h a nd 48h in ICU with death patients were no statistically significant difference, P> 0.05; but COP level after 72h in death patients were significantly lower t han live patients, P< 0.05.5.The correlation analysis of COP,|HCT-ALB|,Lac, CRP,PCT, APACHE II score and SOFA score showed negatively correlated wit h the COP (All P< 0.05, significant respectively were-0.24,-0.21,-0.42,-0.24,-0.35).6. A separate application COP or |HCT-ALB|, Lac, CRP and PCT, APACHE II score and SOFA score of sepsis patients severity evaluation ability of ROC curve analysis results show that the AUC=0.78,sensitivity is 0.64, specificity is 0.43 That COP for evaluating the effect of severe sepsis a nd septic shock, high sensitivity, but the specificity is poor.Conclusions:The colloid osmotic pressure can use as a new indicators to eval uate the severity with sepsis patient. |
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