| 摘要: |
| 目的 研究血脂水平在细菌性肝脓肿中期热毒炽盛证患者中与炎症水平、病情评分的相关性，以及采用不同治疗方案后其变化情况。方法:回顾性选择天津市中西医结合医院收治的细菌性肝脓肿中期热毒炽盛证患者121例，根据治疗前是否存在脓毒症及脓毒性休克分为非脓毒症组27例、脓毒症(非脓毒性休克)组73例、脓毒症(脓毒性休克)组21例，并按治疗方案分为西医治疗组38例、中西医结合治疗组83例，对其血脂水平、炎症水平、器官衰竭(SOFA)评分、急性生理学与慢性健康状况评价系统Ⅱ(APACHE Ⅱ)评分、脓毒症危险因素，以及西医治疗和中西医结合治疗后指标的变化等进行分析。结果:本研究共纳入121例细菌性肝脓肿中期热毒炽盛证患者，该阶段患者治疗前的HDL、LDL与Leukocyte N%、CRP、PCT、SOFA评分及APACHE Ⅱ评分均呈负相关性，多因素Logistic回归分析显示，HDL、PCT以及APACHE Ⅱ评分是脓毒症的危险因素；LDL、PCT以及APACHE Ⅱ评分是脓毒性休克的危险因素。继续进行治疗分组研究显示，中西医结合治疗组患者治疗前后ΔHDL、ΔCRP的绝对值[(+0.54±0.18)mmol/L、(-164.10±75.50)mg/L vs (+0.12±0.14)mmol/L、(-95.94±68.98)mg/L]大于西医治疗组，差异有统计学意义(P＜0.05)。结论:细菌性肝脓肿中期热毒炽盛证患者的血脂水平变化对病情严重程度有提示作用，且中西医结合治疗该类患者有加速炎症恢复、促进病情痊愈、缩短病程时间、减少住院花费的明显优势。 |
| 关键词: 细菌性肝脓肿 中医分期辨证 血脂 脓毒症 |
| DOI：10.3969/j.issn.1007-6948.2025.01.019 |
| 投稿时间：2024-04-26 |
| 基金项目: |
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| Study on the correlation between blood lipid level and condition changes in the middle stage of bacterial liver abscess with severe heat poisoning syndrome |
| CHEN Di,CHEN Ming |
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| Abstract: |
| Objective To study the correlation between blood lipid level, inflammation level and disease score in patients in the middle stage of bacterial liver abscess with Severe Heat Poisoning Syndrome, and the changes of blood lipid level after different treatment schemes. Methods A retrospective study was carried out on 121 patients in the middle stage of bacterial liver abscess with Severe Heat Poisoning Syndrome who were hospitalized in Tianjin Hospital of ITCWM Hospital. Based on the presence of sepsis and septic shock prior to treatment, the patients were divided into three groups: the non-septic group (27 cases), the septic group (non-septic shock) (73 cases), and the septic group (septic shock) (21 cases). Furthermore, patients were categorized by treatment regimen into a Western medicine treatment group (38 cases) and a integrated traditional Chinese and Western medicine treatment group (83 cases). Then analyze their blood lipid level, inflammation level, SOFA score, APACHE Ⅱ score, risk factors of sepsis and changes of indicators after western medicine treatment and integrated traditional Chinese and western medicine treatment. Results In this study, 121 patients were included. Before treatment, HDL and LDL was negatively correlated with Leukocyte N%, CRP, PCT, SOFA score and APACHE Ⅱ score. Multivariate Logistic regression analysis showed that HDL, PCT and APACHE Ⅱ scores were risk factors for sepsis. And LDL, PCT, APACHE Ⅱ scores were risk factors for septic shock. The further study of treatment groups showed that the absolute values of ΔHDL and ΔCRP in the treatment group of ITCWM before and after treatment was higher than that of the Western medicine treatment group[(+0.54±0.18)mmol/L,(-164.10±75.50)mg/L vs (+0.12±0.14)mmol/L,(-95.94±68.98)mg/L], and the difference was statistically significant (P<0.05). Conclusion The change of blood lipid level in patients in the middle stage of bacterial liver abscess with Severe Heat Poisoning Syndrome can prompt the severity of the disease, and the treatment of this kind of patients with ITCWM has obvious advantages in accelerating the recovery of inflammation, promoting the recovery of the disease, shortening the course of disease and reducing the hospitalization expenses. |
| Key words: Bacterial liver abscess TCM staging syndrome differentiation blood lipid levels sepsis |
