探索血清酸盐水平与感染性疾病住院患者的死亡率之间的关联:全国性研究
Amit Frenkel1, Adi Shiloh2, Victoria Vinokur3
1General Intensive Care Department, Soroka University Medical Center, and The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Frontiers in medicine
|April 9, 2024
概括
血清酸盐水平会影响感染性疾病患者的治疗结果. 高水平 (高酸盐血症) 和低水平 (低酸盐血症) 都与增加的死亡率和器官损伤有关,正常水平显示出最好的预后.
科学领域:
- 内部医学 内部医学
- 临床生物化学 临床生物化学
- 传染性疾病 传染性疾病
背景情况:
- 血清酸盐是一种影响细胞功能的关键电解质.
- 住院患者,特别是感染患者中,酸盐平衡的破坏是常见的.
- 在非重症监护病房感染病人的血清酸盐水平的预后意义仍然不完全理解.
研究的目的:
- 调查血清酸盐水平与感染性疾病住院成年人死亡率之间的关联.
- 探索血清酸盐水平与位器官损伤之间的关系.
- 为了确定血清酸盐水平对住院时间的影响.
主要方法:
- 全国范围的回顾性队列研究涉及126,088名成年患者,他们在八家三级医院 (2001-2020年) 接受了感染.
- 服用后第一周内测量的血清酸盐水平作为主要暴露变量.
- 分析采用多变量逻辑回归和量子力回归模型,并根据相关混因素进行调整.
主要成果:
- 死亡率在患有高酸盐血症 (酸盐升高) 的患者中最高,在患有低酸盐血症 (酸盐降低) 的患者中最低,与正常酸盐血症 (正常酸盐) 相比.
- 高酸血症显著增加了目标器官损伤的概率 (OR 2.43),而中度低酸血症显示出保护性关联 (OR 0.73).
- 过光血症与住院时间 (0.33天) 的轻微增加有关.
结论:
- 在感染性疾病患者的血清酸盐水平和预后之间存在J形关系,不论功能如何.
- 超酸血和低酸血都与不良结果有关,包括增加死亡率和器官损伤.
- 维持正常的血清酸盐水平对于感染住院患者的更好的结果至关重要.
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