感染性休克患者血浆游离皮质醇浓度的变化分析

目的 探讨感染性休克患者在发病过程中血浆游离皮质醇浓度的变化情况.方法 对我院ICU收治的57例感染性休克患者的游离皮质醇浓度进行检测,观察其在感染性休克发病过程中的变化情况,并与31例非感染性危重病组及23例健康对照组进行比较.结果 与非感染的危重病组及健康对照组相比,感染性休克组中生存者的游离皮质醇浓度要明显高于其他两组,(2.21±0.45)nmol/L vs(1.12±0.48)nmol/L,(0.44±0.11)nmol/L(P<0.05);而感染性休克的死亡组浓度又高于存活组,(2.69±0.66)nmol/L.vs(2.21±0.45)nmol/L(P<0.05),对感染性休克存活者的分析发现,血浆游离皮质醇浓度随着病情的控制而降低,(2.214±0.45)nmol/L vs(1.52±0.38)nmol/L vs(0.57±0.31)nmol/L(P<0.05).结论 感染性休克患者的血浆游离皮质醇浓度和病情变化有关,可以作为判断预后的一项指标.

Analysis on free cortisol changes of septic shock patients

Objective To investigate the changes of free cortisol in septic shock patients. Methods Free cortisol of 57 septic shock patients in the intensive care unit of the hospital were analyzed,and were compared with that in 31 non-infected critical patients and 23 healthy volunteers. Results The free cortisol in septic shock survivors was higher than that in non-infected critical patients and healthy volunteers, （2.21 ± 0.45） nmol/L vs （1.12± 0.48） nmol/L, （0.44±0.11） nmol/L（ P 〈0. 05）, while in the dead patients of septic shock it was higher than that in surviving septic shock, （2.69±0.66） nmol/L vs （2.21±0.45） nmol/L（ P 〈0.05）. And in the meantime,the free cortisol of surviving patients in septic shock decreased gradually when the patients recovered, （2.21 ±0.45） nmol/L vs （1.52 ±0.38） nmol/L vs （0.57±0.31） nmol/L（ P〈0.05）. Conclusion Free eortisol of septic shock is associated with the severity of the disease and can be a predictor of prognosis.