Observation Of Patients With Severe Pneumonia In ICU Using Trace Elements(multiple Trace Element Injections Ⅱ)

Objective:1.To observe the clinical efficacy and prognosis of trace elements(multiple trace element injection II)in patients with severe pneumonia ICU need mechanical ventilation;2.Identify the risk factors for death within 28 d of mechanical ventilation in patients with severe pneumonia.Methods:1、Review analysis of the data of 2 2 4 cases of severe pneumonia patients receiving ICU from January 2019 to December 2 0 1 9,Collect the application of multiple micro element injection,Consider the age,gender,and APACHEⅡ score differences,Patient 1 : 1 was assigned to the control and observation groups,Get 88 pairs,The control group used routine treatment,The observation group applied multiple-trace element injection II,based on the control group We compared c Tn I、NT-pro BNP、CD4T cells,CD8 T cells and CD4/CD8 ratios,IL-6、CRP、PCT、 acquired muscle weakness,APACHE Ⅱ score,SOFA、 clinical pulmonary infection score(CPIS),counted ventilator-assisted ventilation time,hospital stay,and 2 8-day mortality.2、Taking death within 28 d as the dividing line,224 patients were divided into death group and survival group.The influencing factors of prognosis death were determined by single factor,binary logistic regression analysis.Results:1、SAP30,HAP30 and CAP28 cases were included in the two groups.There was no significant difference between the two groups(P >0.05);2、 There was no significant difference in plasma zinc,iron and copper levels between the two groups before treatment(all P > 0.05).After 14 days of treatment,the levels of plasma zinc,iron and copper ions in the observation group were higher than those before treatment,and the levels of plasma zinc,iron and copper ions in the observation group were higher than those in the control group,the differences were statistically significant;3、The results of cardiac function indexes c Tn I、NT-pro BNP levels of 6,12,24 and 72 h after onset confirmed that the c Tn I、NT-pro BNP of 12 h、24h、72h in the observation group was significantly lower than that in the control group at 6h after onset,and significantly lower than that in the control group at the same time(P <0.05).4、The ratio of CD4 T cells(%)and CD4/CD8 in the observation group was significantly higher than that in the control group at 7 d,and the ratio of CD4 T cells(%)and CD4/CD8 cells(%)increased and the level of CD8 T cells(%)decreased,The CD8 T cells(%)in the observation group decreased more significantly(P<0.05);5、The results of PCT、IL-6、CRP、BLA data collected at admission,3 d、and 7 d confirmed that there was no significant difference in the IL-6、CRP、PCT、BLA level between the two groups(P<0.05).After 7 d of treatment,the inflammatory factors and blood lactic acid levels in the two groups were lower than those in the control group(P<0.05);6、The APACHE II score,SOFA score and CPIS score of the two groups were significantly lower than those of the control group 7 d after treatment(P<0.05);7、The incidence of acquired muscle weakness in the observation group was9.09 %(8/88)and 2 8 d mortality 7.95 %(7/88)than in the control group(P<0.05);There was no significant difference in ventilator assisted ventilation time(7.55±0.80)d and hospitalization time(19.80±2.85)between the observation group and the control group(P>0.05).8、The differences between death group and survival group were mainly in APACHE Ⅱ score,SOFA score,CPIS score,CRP 、 acquired myasthenia,application of compound trace element injection,infection with drug-resistant bacteria,(P<0.05).9、Using 28 d death as dependent variable,independent variables identified by single factor analysis were substituted into binary logistics regression model.It was found that acquired muscle weakness and drug-resistant bacteria infection were independent risk factors for death within 28 d.The application of compound trace element injection was a protective factor for 28 d death(OR<1,P<0.05).Conclusion:1.During the treatment of severe pneumonia patients with mechanical ventilation,the application of compound trace element injection(II)can effectively inhibit the heart function damage,promote the recovery of immune function,reduce the levels of inflammatory factors and blood lactic acid,and reduce the risk of acquired myasthenia.2.However,mechanical ventilation and hospital stay were not optimized,and the protective effect on the risk of death within 28 days was not obvious.