实用老年医学

实用老年医学 ›› 2023, Vol. 37 ›› Issue (9): 890-892.doi: 10.3969/j.issn.1003-9198.2023.09.007

• 临床研究 • 上一篇    下一篇

老年脓毒症病人RNA损伤与28 d死亡率的相关性研究

高戎, 章启东, 杨雯, 祝颖, 杨润华   

  1. 210014 江苏省南京市,南京中医药大学附属南京市中西医结合医院急诊科(高戎,章启东,杨雯);呼吸科(祝颖);重症医学科(杨润华)
  • 收稿日期:2022-10-26 出版日期:2023-09-20 发布日期:2023-09-21
  • 通讯作者: 杨润华,Email: yrhboom@sina.com
  • 基金资助:
    国家自然科学基金青年科学基金资助项目(81701884)

Correlation between RNA damage and 28-d mortality in elderly patients with sepsis

GAO Rong, ZHANG Qi-dong, YANG Wen, ZHU Ying, YANG Run-hua   

  1. Department of Emergency (GAO Rong, ZHANG Qi-dong, YANG Wen); Department of Respiratory Medicine (ZHU Ying); Department of Emergency and Intensive Care Medicine(YANG Run-hua), Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Nanjing 210014, China
  • Received:2022-10-26 Online:2023-09-20 Published:2023-09-21
  • Contact: YANG Run-hua, Email:yrhboom@sina.com

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摘要： 目的 探讨老年脓毒症病人RNA损伤与28 d死亡率的相关性。 方法 选取急诊入院的老年脓毒症病人,根据28 d生存情况分为存活组及死亡组,记录年龄、性别、住院时间、平均动脉压,检测RNA氧化损伤后尿中代谢产物8-氧化鸟苷(8-oxoGuo)浓度等临床实验室指标,并评估APACHE Ⅱ评分和序贯器官衰竭(SOFA)评分,随访病人28 d死亡率。比较存活组和死亡组之间上述指标的差异,分析影响老年脓毒症病人28 d死亡的危险因素。采用ROC曲线分析不同指标对老年脓毒症病人28 d死亡的预测价值。 结果 8-oxoGuo、APACHEⅡ评分、SOFA评分和去甲肾上腺素(NE)用量是影响老年脓毒症病人28 d死亡的危险因素(P<0.05)。8-oxoGuo对病人预后有较高的预测价值(AUC=0.847,Z=6.397,P<0.001),其预测死亡风险的特异度和灵敏度分别是87.5% 和70.8%。 结论 RNA氧化损伤与老年脓毒症病人的不良预后显著相关。

关键词: 脓毒症, 老年人, RNA损伤, 死亡率

Abstract: Objective To investigate the correlation between RNA damage and 28-d mortality in the elderly patients with sepsis. Methods The elderly patients with sepsis admitted to Department of Emergency were enrolled in this study. The data of age, gender, length of stay, mean arterial pressure, clinical laboratory indicators such as 8-oxoGuo concentration in urine after RNA oxidative damage, the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score and Sequential Organ Failure Assessment(SOFA) score were recorded. The mortality rate of the patients was recorded after 28-d follow-up. The differences in the indicators between the survival group and the death group were analyzed, and the risk factors of 28-d mortality were analyze. Receiver operator characteristic curve analysis was used to evaluate the predictive value of the factors for 28-d mortality in the elderly patients with sepsis. Results 8-oxoGuo, APACHE Ⅱ score,SOFA score and dosage of norepinephrine were risk factors for 28-d mortality of the elderly patients with sepsis (OR=1.559, 2.065, 1.223, 11.602, respectively). 8-oxoguanosine had a high predictive value for 28-d mortality (AUC=0.847,Z=6.397,P<0.001), and the specificity and sensitivity was 87.5% and 70.8%, respectively. Conclusions Oxidative RNA damage is associated with 28-d mortality in the elderly patients with sepsis.

Key words: sepsis, aged, RNA damage, mortality

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