急性呼吸窘迫综合征患者血钾和血钠水平及其与患者近期预后的相关性研究

摘要

目的：探讨急性呼吸窘迫综合征患者血钾和血钠水平的变化及其与患者近期预后的相关性。方法选取急性呼吸窘迫综合征患者146例作为观察组，于入院前（T0）、入院3 h（T1）、6 h（T2）、12 h（T3）、1d（T4）和3d（T5）时抽取静脉血检测患者血钾及血钠水平。另选取30例同期健康体检者为对照组。统计观察组同期 APACHE II 评分和院内死亡情况并分析患者血钾及血钠水平与 APACHE II 评分和院内死亡的关系。结果观察组各时间点血钾和血钠水平均明显低于对照组（P ＜0．05），APACHE II 评分明显高于对照组（P ＜0．05）。观察组住院期间死亡率为24．66％，死亡患者血钾和血钠水平均低于存活患者，APACHE II 评分则高于存活患者（P ＜0．05）。急性呼吸窘迫综合征患者血钾和血钠水平与 APACHE II 评分均呈负相关（r 分别为－0．961和－0．984，均 P ＜0．05），与院内病死率亦呈负相关（r 分别为－0．754和－0．772，均 P ＜0．05）。结论急性呼吸窘迫综合征患者血钾和血钠水平较低且均与其 APACHE II 评分和病死率相关，可作为其近期预后评估的参考指标。%Objective To investigate the changes in blood levels of potassium and sodium in patients with acute respiratory distress syndrome and its correlation with short -term prognosis of patients.Methods One hundred and forty-six patients with acute re-spiratory distress syndrome were selected as the observation group .Venous blood samples were collected before admission (T0 ),after admission of 3 h (T1 ),6 h (T2 ),12 h (T3 ),1d (T4 ) and 3d (T5 ).The blood levels of potassium and sodium were analyzed with a blood gas analyzer.Thirty healthy volunteers were used as controls .APACHE II score of the same period in the observation group were statistically analyzed and relationship between blood levels of potassium and sodium and APACHE II score as well as in -hospital death situation were analyzed.Results Blood levels of potassium and serum sodium in the observation group were significantly lower than that in the control group (P <0.05).The APACHE II score in the observation group was significantly higher than that in the control group (P <0.05).The mortality rate in the observation group was 24.66% during hospitalization.The blood levels of potassium and serum sodium levels in the death patients were lower while APACHE II score was higher than that in survival patients (P <0.05).The blood levels of potassium and sodium were negatively correlated with APACHE II score (r=-0.961 for potassium vs.APACHE II score and -0.984 for sodium vs.APACHE II score,respectively,P <0.05) in the patients.The blood levels of potassium and sodium were also negatively correlated with hospital mortality rate (r=-0.754 for potassium vs.mortality rate and -0.772 for sodium vs.mortality rate,respectively,P <0.05) in the patients.Conclusion Blood potassium and sodium levels in patients with acute respiratory distress syndrome are low and related with APACHE II score and hospital mortality rate .It may be used as indicators for short-term prognosis as-sessment.