Relationship between Intestinal Flora Imbalance and Delirium in ICU Patients with Sepsis
ICU脓毒血症患者肠道菌群失调与谵妄的相关性研究

摘要

目的：探讨重症加强护理病房(ICU)脓毒血症患者肠道菌群失调与谵妄的相关性。方法：选取2017年3月~2019年9月于我院ICU接受治疗的160例脓毒血症患者，收集粪便测定肠道菌群分布、浓度情况，予以对症治疗后随访10d观察患者谵妄情况，并分别分为谵妄组与非谵妄组，分析ICU脓毒血症患者肠道菌群失调与谵妄发生的相关性。结果：经10d随访后，160例ICU脓毒血症患者发生谵妄47例，未发生谵妄113例；对比两组性别、年龄及BMI，差异无统计学意义(P＞0.05)；谵妄组拟杆菌(Bac303)、乳酸杆菌(Lab158)水平高于非谵妄组，谵妄组梭菌属(His150)水平低于非谵妄组，差异有统计学意义(P＜0.05)；经Logistic回归分析结果显示，肠道菌群失调是导致ICU脓毒血症患者谵妄的影响因素(OR＞1，P＜0.05)。结论：ICU脓毒血症患者发生谵妄可能与其肠道菌群失调有关，临床可考虑通过检测ICU脓毒血症患者肠道菌群分布情况以预测谵妄发生风险，对改善预后有积极意义。

Abstract

Objective:To explore the correlation between intestinal flora imbalance and delirium in patients with sepsis in intensive care unit(ICU).
Methods:160 patients with sepsis in ICU of our hospital from March 2017 to September 2019 were selected.The feces were collected to determine the distribution and concentration of intestinal flora.After symptomatic treatment,the patients were followed up for 10 days to observe the delirium.They were divided into delirium group and non delirium group.The correlation between intestinal flora imbalance and delirium was analyzed.
Results:After 10 days of follow-up,47 patients developed delirium and 113 patients did not;There was no significant difference in gender,age and BMI between the two groups(P>0.05);BAC 303 and lab 158 levels in delirium group were higher than those in non delirium group,and his150 level in delirium group was lower than that in non delirium group(P<0.05);Logistic regression analysis showed that intestinal flora imbalance was the influencing factor of delirium in ICU patients with sepsis(or>1,P<0.05).
Conclusion  :The occurrence of delirium in patients with sepsis in ICU may be related to the imbalance of intestinal flora.The detection of the distribution of intestinal flora in patients with sepsis in ICU can be considered to predict the risk of delirium,which has positive significance for improving the prognosis.