2型糖尿病伴感染性休克患者尿酸与预后的关系

doi:10.3969/j.issn.1002-1949201810006

Chinese Journal of Critical Care Medicine

Effects of uric acid to prognosis of type 2 diabetes patients with septic shock

Department of Critical Care Medicine, Anhui Provincial Hospital, Hefei 230000， China

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Abstract Objective To analysis the correlation between serum uric acid and short-term prognosis on ICU patients with type 2 diabetes mellitus (T2DM) and septic shock. Methods A prospective cohort study of 126 T2DM patients with septic shock in ICU was divided into 2 groups. The death group (n=33) and living group (n=93). General data of patients sex, age, PCT, Lac, Hba1c, FPG, duration of diabetes, UA, APACHEⅡscores on admission and minimum concentration of uric acid was measured and recorded. Results There were no significant differences of HbA1c, FPG and duration of diabetes on admission between survival group and death group, but Lac and APACHEⅡscores of the death group on admission were significantly higher than the survival group ［Lac:(2.95±1.71) mmol/L vs. (5.03±3.06) mmol/L, P=0.028; APACHEⅡ:(18.12±5.06) vs. (23.91±7.79)，P=0.040］, UA of the death group were significantly lower than those of the survival group ［(363.08±169.79)μmol/L vs. (268.06±111.84) μmol/L, P=0.001］. The related factors were analyzed by Logistic Regression Model, showing that UA, APACHEⅡ scores are statistically different between two groups (P<0.05). UA levels in patients on admission and minimum were negative correlated with APACHEⅡ score (Rwere -0.379 and -0.634, P<0.05). The area under the receiver operating characteristic curve was 0.666, 0.840 respectively, according to the level of the UA at baseline and minimum concentration. The cut off of minimum UA was 226.5 μmol/L, resulting in a sensitivity of 78% and a specificity of 86%. Conclusion Study had shown that the lower concentration of UA was associated with unfavorable prognosis in ICU patients with T2DM and septic shock. The minimum concentration of UA might be the indicator for predicting the condition of patients and UA equal to 226.5 μmol/L can be used as a cutoff point.

Key words： Uric acid Sepsis shock 28-day mortality Risk factor

Corresponding Authors: Huang Bin, E-mail: huangvigrous@163.com

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949201810006 OR http://www.cnemergency.org.cn/EN/Y2018/V38/I10/859

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