预测败血症引起的急性损伤的炎症参数:一个病例对照研究
Dajana Lendak1,2, Dunja Bečejac3, Sonja Mitić3
1Department for Infectious Diseases, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, Serbia. dajana.lendak@mf.uns.ac.rs.
BMC infectious diseases
|September 27, 2025
概括
炎症标志物,如C-反应蛋白 (CRP) 和前素 (PCT) 是导致败血症的急性损伤 (SI-AKI) 的关键预测因素. 升高的CRP和PCT水平,以及SOFA得分,可以帮助识别患有SI-AKI风险的患者.
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
- 传染性疾病 传染性疾病
背景情况:
- 败血症引起的急性损伤 (SI-AKI) 越来越多地被认为是多因素的,包括炎症,免疫反应,缺血-再输液和低血压.
- 传统观点侧重于低血压症,但当前的理解强调了导致SI-AKI的因素的复杂相互作用.
研究的目的:
- 评估炎症参数 (白细胞,中性粒细胞,淋巴细胞,中性粒细胞与淋巴细胞比率 (NLR),C反应蛋白 (CRP),公素 (PCT)) 和平均动脉压 (MAP) 对SI-AKI发展的预测意义.
- 在败血症患者中确定SI-AKI的独立预测因子.
主要方法:
- 分析了一组257名败血症患者 (败血症-3标准),分为有SI-AKI和没有SI-AKI的组.
- 统计分析包括曼-惠特尼测试,斯皮尔曼相关性,ROC曲线分析和二进制物流回归.
- 对所有参与者进行了全血细胞计,CRP,PCT,SOFA和qSOFA评分的评估.
主要成果:
- 与非SI-AKI组相比,SI-AKI组中观察到CRP,PCT和NLR的水平更高.
- CRP和PCT与肌素水平有显著的相关性,并与SOFA评分一起被确定为SI-AKI的独立预测因子.
- 在SI-AKI患者中,平均动脉压 (MAP) 显著降低. 在ROC分析中,CRP≥199 mg/L和PCT≥13 ng/L被确定为预测性切线值.
结论:
- 炎症反应在SI-AKI的发展中起着重要作用.
- CRP和PCT是预测败血症患者SI-AKI的有价值的生物标志物.
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