双心室收缩功能对脓毒症和感染性休克患者死亡率的影响

Elif Tükenmez Tigen, A. Kepez, M. Sünbül, B. Özben, Buket Ertürk Şengel, B. Bilgili, Ş. Olgun Yıldızeli, K. Tigen
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引用次数: 0

摘要

目的:我们旨在评估脓毒症或感染性休克患者的左心室(LV)和右心室(RV)收缩性能以及可能的功能改变对住院死亡率的影响。患者和方法:37例连续诊断为败血症或感染性休克的患者纳入研究。所有患者均行全面的经胸超声心动图检查。将重症监护病房出院患者的数据与医院死亡患者的数据进行比较。结果:存活15例(40.5%),院内死亡22例(59.5%)。除BNP (p=0.01)和SOFA (p=0.009)评分外,存活组和非存活组在出院前或死亡前炎症标志物如CRP (p=0.05)和降钙素原(p=0.03)水平上均有显著差异。研究人群中EF值小于50%的患者有2例(5.4%)。8例(21.6%)患者表现为鼻尖节段运动不足,4例(10.8%)患者TAPSE值低于17 mm。生存组1例(6.6%),非生存组7例(31.8%)出现尖顶运动减退,差异有统计学意义(p=0.068)。存活组1例(6.6%),非存活组3例(13.6%)存在右室收缩功能障碍(p: 0.51)。结论:与以往的研究相比,我们发现脓毒症或感染性休克患者左室和右室收缩功能障碍的发生率明显降低。没有心肌功能障碍类型与住院死亡率相关。顶端运动障碍在非幸存者中也更为普遍,尽管存在临界意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of Bi-ventricular systolic function on mortality in patients with sepsis and septic shock
Objectives: We aimed to evaluate left ventricular (LV) and right ventricular (RV) systolic performance in patients with sepsis or septic shock and possible functional alteration on in-hospital mortality. Patients and Methods: Thirty-seven consecutive patients with the diagnosis of sepsis or septic shock were included in the study. All patients underwent comprehensive transthoracic echocardiographic examination. Data of patients discharged from the intensive care unit was compared with data of patients who died in the hospital. Results: Fifteen patients (40.5%) survived, while 22 patients were died in the hospital (59.5%). A significant difference was detected between survivor and non-survivor groups regarding before discharge or death level of inflammatory markers such as CRP (p=0.05) and procalcitonin (p=0.03) besides BNP (p=0.01) and SOFA (p=0.009) score. There were two patients (5.4%) with EF value less than %50 in the study population. Eight patients (21.6%) displayed hypokinesia on the apical segment, and four patients (10.8%) had TAPSE values below 17 mm. One patient (6.6%) in the survivor group, but seven patients (31.8%) in the non-survivor group had apical hypokinesia with a trend towards significance (p=0.068). One patient in the survivor group (6.6%) and three patients (13.6%) in the non-survivor group had RV systolic dysfunction (p: 0.51). Conclusion: We found a much lower rate of LV and RV systolic dysfunction in patients with sepsis or septic shock compared with previous studies. None of the myocardial dysfunction types was associated with in-hospital mortality. Apical hypokinesia was also more prevalent in non-survivors despite borderline significance.
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