严重脓毒症早期性激素水平与器官损伤的相关性及对预后的影响

目的:探讨严重脓毒症患者早期血清性激素水平与器官损伤之间的相关性及对预后的影响。方法:回顾性分析53例男性严重脓毒症患者的临床资料,收集患者72 h内血清睾酮(T)、雌二醇(E2)和催乳素(PRL)水平,并进行Marshall和APACHEⅡ评分,4周后根据存活情况分为存活组和死亡组,另外选择同期20例男性健康体检者作为对照组。结果:存活组32例,死亡组21例;存活组的血清T低于死亡组和对照组(均P0.01),血清E2和PRL水平高于死亡组和对照组(均P0.05),Marshall和APACHEⅡ评分均低于死亡组(均P0.01);死亡组血清E2显著低于对照组(P0.01),血清T和PRL与对照组无显著差异(P0.05),但呈降低趋势;生存组和死亡组Marshall评分与血清T呈正相关(r=0.637),与血清E2和PRL呈负相关(r分别为-0.732和-0.654,均P0.05)。结论:严重脓毒症早期患者血清T、E2和PRL水平与器官功能的损伤程度密切相关,血清高E2、PRL和低T水平可能具有保护器官的作用。

The relationship of serum sex hormone levels in the patients in the early age on organ damage and its influence on prognosis

Objective: To observe the relationship of serum sex hormone levels in the patients in the early age on organ damage and its influence on prognosis. Methods: A retrospective collection 53 cases male patients with severe sepsis in our hospital center ICU from 2012.01 to 2014.12, all within 72 hours after admission blood serum testosterone (T), estradiol (E₂) and prolactin (PRL) levels, and at the same time Marshall score and APACHE II score was performed, according to survive state after four weeks survival group and death group was divided, and select 20 cases from other men"s health physical examination as control group. Results: The survival group were 32 cases, death group were 21 cases; Survive group have lower serum T than that of death and the control group (P<0.002), serum E₂ and PRL is significantly higher than that of the death group and the control group (P <0.05), the survival group Marshall score and APACHE II scores were significantly lower than the death group (P<0.001); Death group serum E₂ was significantly lower than control group (P<0.001), serum T and PRL and the control group had no significant difference (P>0.05), but it showed a trend of decrease; Survival group and death. Survival group and death group Marshall score was positively correlated with serum levels of T (r=0.637), and negatively correlated with serum E2 and PRL (r =-0.732 and -0.654, respectively), (P<0.05). Conclusions: patients with severe sepsis early serum T, E₂ and PRL level is closely related to the damage degree of organ function, high serum E₂, PRL and low level of T possible protective effect of organs, can be used as a judge of one of the indicators.condition and prognosis.