败血症患者急性损伤与凝血功能障碍之间的关系和预后
Zhenyi Wang1, Shimin Dong1, Yanjun Qin1
1Department of Emergency, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, People's Republic of China.
Open access emergency medicine : OAEM
|July 9, 2024
概括
败血症相关凝血病 (SAC) 的严重程度,特别是3级或4+的得分,显著影响患者的预后. 急性损伤进一步恶化SAC,对败血症患者的结果产生负面影响.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
背景情况:
- 败血症是一种危及生命的器官功能障碍,是由宿主对感染的反应失调引起的.
- 败血症相关的凝血病 (SAC) 是一种常见的并发症,严重影响患者的治疗结果.
- 急性损伤 (AKI) 经常在败血症中观察到,可能会影响凝血病.
研究的目的:
- 为了研究急性损伤 (AKI) 和败血症患者的凝血病之间的关系.
- 探索AKI和败血症相关凝血病 (SAC) 的预后价值.
主要方法:
- 对271名患有凝血病的败血症患者的回顾性审查.
- 使用t测试对实验室参数,APACHE II和SOFA分数进行生存和非生存组的比较.
- 斯皮尔曼相关性,ROC曲线和考克斯回归来分析影响预后的因素.
主要成果:
- 血清肌素 (Scr) 与SAC分类和得分 (r > 0.7) 有很强的相关性.
- 随着SAC严重程度的增加,生存率显著下降 (轻度:77.6%的生存率;中度:21.5%的生存率;严重:0.7%的生存率).
- 预测不良结果的预测因素包括MODS,SOFA得分,INR和Scr水平;SOFA,APACHE II和SAC分类显示出高预测值 (AUC>0.8).
结论:
- 较高的SAC等级 (≥3) 或得分 (≥4) 与败血症的预后较差有关.
- AKI会加剧SAC,进一步恶化败血症患者的预后.
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