Clinical analysis of decreased vasopressin modulation in the late phase of septic shock
ZHOU Qingming
WANG Chunling
YANG Xiufen
SUN Jingna
LI Dongliang
WANG Lai
Abstract：Objective To investigate the abnormal regular pattern and prognostic value of vascular vasopressin ( VP) secretion in patients with late infection shock .Methods From 2012 January to 2014 February, 55 patients with septic shock were enrolled , serum sodium and serum level of VP , Delta VP/Delta Na were measured before and after the infusion of 3%Sodium Chloride Solution,△VP/△Na less than or equal to 0.5 pg/mmol were defined as non-response group,△VP/△Na >0.5 pg/mmol were definded as response group , levels of blood lactic acid, C reactive protein, differences in drug application of vasoactive and 28 d mortality rate , survival time of death patients , ICU stay time of survivors were compared between the 2 groups.Results Non-response group has 30 cases (54.5%), response group has 25 cases (45.5%).2 groups of patients’ gender,age, APACHE II score, central venous pressure ( CVP), blood pressure, plasma albumin level revealed no diffe-rences ( t =-0.563, t =-0.596, t =-0.712, t =0.779, t =1.306, P >0.05), the differences in the level of serum sodium transport before and after injection of hypertonic saline had no statistical significance (χ2 =0.267, t =0.257, t =0.233, P >0.05), VP transmission level before and after the injection of hypertonic saline (ng/L) in the non-response group were lower than those of response group (10.66 ±1.57 vs.17.13 ±5.12, t =6.091, P <0.01;11.65 ±1.74, vs.22.50 ± 5.31, t =9.758, P <0.01).Blood lactic acid, C reactive protein level and the dose of dopamine or norepinephrine in the Non-response group were higher than those of response group ( t =-5.881, t =-4.143, t =-5.725, t =-5.625, re-spectively, P <0.01).28 day’s mortality of non-response group was higher than that of response group (66.7%vs.40.0%,χ2 =3.911, P <0.05);(death patients) survival time revealed no significant difference between the 2 groups, (5.8 ±1.9) d vs.(6.1 ±2.3) d, t =0.384, P =0.704;(survivors) ICU stay time in the non-response group was higher than that of re-sponse group [(9.9 ±2.3) d vs.(6.7 ±1.7) d, t =-4.044, P <0.01].Conclusion Septic shock patients in late phase revealed high incidence of osmotic regulated VP secretion disorder , it has predictive value in patients ’ evaluation.
Keywords：VasopressinShocksepticPrognosticOsmotic pressure
Publication Date：2014-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 1247-1250 )