Influencing factors of serum calcium and the role of serum calcium on prognosis in sepsis patients / 中国医师进修杂志

ABSTRACT

Objective@#To retrospectively analyze the serum calcium level in sepsis patients, understand the influencing factors of abnormality calcium metabolism, and analyze the effect of serum calcium level on sepsis prognosis.@*Methods@#From January 1, 2017 to January 31, 2018, clinical data about sepsis patients admitted hospital were collected. The patients were divided into 2 groups according the levels of serum calcium measured in patients admitted in 24 h normal serum calcium group (serum calcium 2.03-2.67 mmol/L), and low serum calcium group (serum calcium<2.03 mmol/L). And this study did not find hypercalcemia patients. The data about laboratory test index were compared between two groups.@*Results@#Fifty-two cases were included in this study, including 14 cases of normal serum calcium and 38 cases of hypocalcemia, and the incidence rate of hypocalcemia was 73.1%(38/52). The level of serum calcium in hypocalcemia group was (1.78 ± 0.17) mmol/L, and was (2.16 ± 0.14) mmol/L in normal serum calcium group. The main position of infections in patients with sepsis were digestive system, respiratory system and urinary system. Compared with that in the normal serum calcium group, the number of malnutrition patients in the hypocalcemia group was more. The total protein (TP), albumin (ALB), prealbumin (PAB) and total cholesterol (TCH) in the nutritional status of the patients were lower, the sequential organ failure assessment (SOFA) scores was higher, the prothrombin activity (PTA) was lower, the prothrombin time (PT) was prolonged, and international normalized ratio (INR) was increased. The differences were statistically significant (P<0.05 or <0.01). Pearson correlation test was used to screen the tests and scores related to the concentration of serum calcium. The results showed that the serum calcium concentration was negatively correlated with the level of SOFA scores, procalcitonin (PCT), PTA, thrombin time (PT), activated partial thromboplastin time (APTT) and INR (r=- 0.431, - 0.361, - 0.441, - 0.431, - 0.427, - 0.420, P<0.01 or<0.05), and the serum calcium concentration was positively correlated with TCH, TP, ALB and PAB (r=0.442, 0.475, 0.463, 0.419, P<0.01).@*Conclusions@#Hypocalcemia is related to the nutritional status of the body, and is related to coagulation function, serum protein level, PCT concentration and SOFA scores. The decrease of serum calcium indicates that multiple organ dysfunction syndrome may occur, and should be paid more attention to.