ABSTRACT
Objective:To investigate the correlation of lung ultrasound score and poor prognosis in internal shock patients in intensive care unit (ICU).Methods:The clinical data of 200 shock patients admitted to the ICU of Wuzhou Red Cross Hospital from July 2019 to June 2021 were selected for study. According to the prognosis of patients, they were divided into survival group and death group. The clinical data of shock patients in ICU with different prognosis were analyzed by single factor analysis, multiple factor regression analysis and predictive value analysis.Results:All patients were followed up. The end point of the study was death or transfer from ICU. The follow-up period was 28 days, with a median of 16 days. The 28-day survival rate (OS) of all patients was 62.5%(125/200). The Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score, prothrombin time (PT), Fbg, D-dimer(D-D), lactic acid, oxygenation index and lung ultrasound score of the patients in the survival group and the death group were significantly different (all P<0.05), while other indexes were not significantly different (all P>0.05). The results of COX multivariate analysis showed that APACHE Ⅱ score, lactate, and lung ultrasound score were independent prognostic factors of shock patients in ICU (all P<0.05). The survival curves of patients with different lung ultrasound scores were significantly different ( P<0.05). The higher the lung ultrasound score, the lower the 28-day survival rate ( P<0.05). The receiver operating characteristic(ROC) curve analysis showed that the area under curve (AUC), sensitivity and specificity of predicting the prognosis of patients with lung ultrasound score were 0.753, 76.0% and 71.2%, respectively; The AUC , sensitivity and specificity of APACHE Ⅱ score were 0.774, 77.3% and 79.2% respectively; The AUC, sensitivity and specificity of lactic acid were 0.783, 81.3% and 68.8% respectively, with no significant difference (all P>0.05). Conclusions:The lung ultrasound score , lactic acid and APACHE Ⅱ scores are independent risk factors affecting the prognosis of ICU shock patients, and have considerable predictive value.
ABSTRACT
Objective To study the dynamic changes of plasma C-reactive protein (CRP) and cortisol (COR) and their clinical value in prognosis of patients with sepsis. Methods Daily CRP and COR detection was conducted to record the dynamic changes of CRP and COR for cases of sepsis patients in ICU then the rela-tionship between dynamic changes of serum CRP and COR and prognosis were analyzed. Results Serum CRP and COR levels of dead patients were significantly higher than those of survival patients after treatment (P <0.05). According to the difference of the dynamic changes of CRP and COR, the data were divided into typeⅠ:sustained elevated type , typeⅡ: up-and-down type , type Ⅲ: fluctuated type and type Ⅳ: normal or mild ele-vation type. The mortality of CRP typeⅠ patients was significantly higher than that of type Ⅱ and type Ⅳ(P <0.001). The mortality of COR typeⅠ and COR Ⅲ patients was significantly higher than that in COR Ⅱand COR Ⅳ (P < 0.001). Further analysis showed that the mortality of group with significant elevation of CRP and COR were obviously higher than that of group with significant increase of CRP or COR and that of group with no significant elevation of CRP and COR (P < 0.001); the mortality of group with significant increase of CRP or COR was also significantly higher than that of group with no significant elevation of CRP and COR (P < 0.001). Conclusions The dynamic changes of COR and CRP in patients with sepsis present certain regularity and monitor-ing the dynamic changes of the two provides accurate assessment of the prognosis of sepsis.