Characteristics of serum cholesterol in sepsis patients and its correlation with prognosis / 中国医师进修杂志

ABSTRACT

Objective To analyze the characteristics of changes in serum cholesterol level in sepsis patients,and to explore its correlation with prognosis.Methods A retrospective analysis was conducted.Two hundred and six patients with sepsis admitted in the Third People's Hospital of Dalian from February 2015 to February 2019 were enrolled (observation group),and 206 patients without sepsis hospitalized in the same period were served as control group.The basic clinical data of the two groups were collected,and the results of total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C) and biochemical parameters were compared.The patients with sepsis were divided into death group and survival group,and risk factors influencing the prognosis of patients with sepsis were analyzed with Logistic regression analysis.Results Compared with control group,the levels of serum TC [(2.49 ± 1.14) mmoFL vs.(3.40 ± 1.26) mmoFL,t =6.240] and HDL-C [(1.66 ± 0.89) mmol/L vs.(2.49 ± 0.81) mmol/L,t =5.532] in observation group were significantly lower (P ＜ 0.05),and that of LDL-C showed no statistically significant difference [(1.96 ± 0.91) mmol/L vs.(2.10 ± 0.72) mmo/L,t =0.940,P＞0.05].In observation group,the patients in death group (85 cases)were older than those of the survival group (121 cases)[(75.6 ± 8.6) years vs.(62.5 ± 6.0) years,t =4.565],serum creatinine (SCr) was higher than that of survival group [(246.2 ± 34.6) μmol/L vs.(165.4 ± 35.6)μ mol/L,t =5.420],and the levels of serum TC [(2.15 ± 0.59) mmol/L vs.(2.89 ± 1.02) mmol/L,t =5.475],HDL-C [(1.40 ± 0.42) mmol/L vs.(1.94 ± 0.52) mmol/L,t =4.856] and LDL-C [(1.73 ± 0.56)mmol/L vs.(1.97 ± 0.72) mmol/L,t =4.261] were significantly lower than those of survival group (P＜0.05).Logistic regression analysis showed that age was the risk factor of death in sepsis patients (OR =1.256,95％ CI 1.006-1.056,P=0.012),and TC was the protective factor for the prognosis of sepsispatients (OR =-0.758,95％CI 0.579-0.867,P =0.014).Conclusions The levels of TC,HDL-C in sepsis patients are significantly lowered,and the levels of TC,HDL-C,LDL-C in death group are significantly lower than those in survival group.TC may be used as a clinical indicator to assess the outcome of sepsis patients.