The Research Of Liver Dynamic Change In Sepsis Hospital Mortality

Objective To investigate the correlation in the mortality of the patients of sepsis in the hospital and the index level dynamic change of liver function.To observe the dynamic changes of liver function impact on the prognosis of sepsis.To improve the clinical value and management of the changes of liver function in patients who have the sepsis.Methods The clinical data of 80 patients who suffered from sepsis were retrospectively analyzed in January 2013 to December 2016 in the intensive care unit of GuangXi medical university affiliated tumor hospital.The including criteria of sepsis accordance with 3.0 diagnostic criteria for sepsis which was jointly issued by Society of Critical Care Medicine(SCCM)in 2016 and European society intensive care medicine(ESICM).Exclusion criteria included:the patients were transferred to the ICU less than 3 days;the patients had a history of Chronic liver damage;the patients who lived in the ICU caused the acute liver dysfunction or the chronic liver dysfunction in acute attack;after liver cancer resection or partial hepatectomy;the patients gave up treatment because of economic reasons and the cases of incomplete data collection.Grouping:According to the condition when the patients discharged from hospital with sepsis was divided into Improvement,no change,degradation and death,no change,degradation,and death.According to the illness condition put these patients into death(D)or survival(S)group.There are 26 patients in D group and 54 patients in S group.Collecting 8 indicators of liver function of the sepsis patients who transferred to the ICU in the first day(Tl),the third day(T2),the fifth day(T3),the seventh day(T4)and the ninth day(T5)in two groups.The 8 indexes including,TP,ALB,PA,ALT,AST,AKP,TBIL and TBA.To compared and analyzed the dynamic changes of index level in the two groups.Results ?the patient's sex structure ratio,age is no statistical significance between groups(P>0.05).?Total protein group D>group S in T1,T2 point,comparative differences between groups was statistically significant(P<0.05);albumin group D>group S in T1 point,T5 point albumin<group S,comparative differences between groups was statistically significant(P<0.05);prealbumin group D<group S in T5 point,comparative differences between groups was statistically significant(P<0.05).?ALT group D>group S in T1,T2,T4,T5 point,comparative differences between groups was statistically significant(P<0.05);AST group D>group S in T1,T3,T4,T5 point,comparative differences between groups was statistically significant(P<0.05);AKP group D>group S in T1,T2,T3,T4,T5 point,comparative differences between groups was statistically significant(P<0.05).?Comparing differences between total bilirubin in the 5 point group had no statistical significance(P>0.05).TBA group D>group S in T5 point,comparative differences between groups was statistically significant(P<0.05).?The results of correlation analysis:The variation of total protein in T2 to T3,T4 to T5 stage to express negative correlation relationship between survival and death;The change of prealbumin in T3 to T4 stage to express negative correlation relationship between survival and death;The variation of AST in T3 to T4 stage to express positive correlation relationship between survival and death(P<0.05).Conclusion The sepsis patient's AST and APK level of the death group in the hospital was significantly higher than the survival group and higher than normal.High levels of AST and AKP represented the patient's poor prognosis.The gradual rise in AST were significantly associated with sepsis in death.The gradual rise in TP,PA significantly associated with sepsis in survival.