目的：探讨血管加压素的使用对重症患者预后的影响。方法：回顾性分析美国重症医学信息监护数据集Ⅲ（Medical Information Mart for Intensive Care-Ⅲ,MIMIC-Ⅲ）重症患者的基本信息及临床资料,使用倾向性评分匹配法及COX多因素回归分析,探讨血管加压素对重症患者预后的影响。结果：共纳入MIMIC-Ⅲ中57 785例重症患者,其中有2 171例患者使用血管加压素。采用倾向性评分匹配方法对使用血管加压素治疗的患者和未使用血管加压素治疗的患者进行1∶1匹配,共1 168对患者匹配成功。匹配后使用血管加压素组与未使用血管加压素组相比,其院内死亡率、30 d死亡率、1年死亡率以及长期死亡率更高,住院时间及住重症监护病房（intensive care unit, ICU）时间均显著延长。COX多因素回归分析发现,血管加压素的使用是院内死亡率[风险比（hazard ratio, HR）=2.44, 95%置信区间（confidence interval,CI）：2.147~2.772, P<0.001]、30 d死亡率（HR=2.205, 95%CI：1.940~2.505, P<0.001）、1年死亡率（HR=1.999, 95%CI：1.781~2.242, P<0.001）以及长期死亡率（HR=1.891, 95%CI：1.698~2.107, P<0.001）增加的独立危险因素。结论：本研究利用倾向性评分匹配法及COX多因素回归分析进行大样本回顾性研究,发现血管加压素的使用是影响重症患者预后的独立危险因素。

Objective To investigate the effect of vasopressin on the prognosis in the patients with critical condition. Methods The basic information and clinical data of the patients in critical condition in American intensive care database Medical Information Mart for Intensive Care-Ⅲ(MIMIC-Ⅲ) were retrospectively analyzed. The influence of vasopressin on the prognosis of the patients in critical condition was investigated by propensity score matching method and Cox multivariate regression analysis. Results A total of 57 785 patients in critical condition were selected from the MIMIC-Ⅲ database, in which 2 171 were treated with vasopressin. Propensity matching method was used to match 1∶1 between the patients treated with vasopressin and the patients treated without vasopressin. A total of 1 168 patients were successfully matched. The mortality of in-hospital, 30 d, 1-year and long-term in the group using vasopressin were higher than the group treated without vasopressin after matching, and the time staying in hospital and intensive care unit (ICU) were significantly longer in the vasopressin group after matching. Cox multivariate regression analysis showed that using vasopressin was an independent risk factor for increased in-hospital mortality[hazard ratio(HR)=2.44, 95% confidence interval(CI): 2.147-2.772, P<0.001], 30 d mortality (HR=2.205, 95% CI:1.940-2.505, P<0.001), 1-year mortality (HR=1.999, 95% CI: 1.781-2.242, P<0.001) and long-term mortality (HR=1.891, 95% CI: 1.698-2.107, P<0.001). Conclusions This study used propensity score matching method and Cox multivariate regression analysis to conduct a large sample retrospective study, and showed that the using vasopressin is an independent risk factor for the prognosis of the patients with critical condition.