在基于血糖轨迹的基础上,在儿科败血症中识别新型表型
Ying Wang1, Wanqin Song1, Shaojun Li2
1Department of Critical Care Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.
Frontiers in pediatrics
|November 24, 2025
概括
基于小组的轨迹建模在儿科败血症中确定了四种血糖模式. 持续严重的高血糖独立预测死亡率,而缓慢恢复的低血糖会使性休克的结果恶化.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 代谢障碍 代谢障碍 代谢障碍
- 败血症的研究研究.
背景情况:
- 代谢异质性显著影响败血症的预后.
- 了解血糖模式对于管理儿科败血症至关重要.
研究的目的:
- 通过基于组的轨迹建模 (GBTM) 在儿科败血症中识别出不同的血糖轨迹表型.
- 调查这些表型与临床结果之间的关联,包括住院死亡率.
主要方法:
- 一项对1178名儿科败血症患者 (2014-2022) 的回顾性队列研究.
- 动态血糖数据是在ICU入院后72小时内收集的.
- 用于表型分类的GBTM和用于结果预测的多变量逻辑回归.
主要成果:
- 确定了四种血糖表型:缓慢恢复的低血糖 (13.79%的死亡率),正常血糖 (5.10%的死亡率),持续的轻度高血糖 (8.26%的死亡率) 和持续的严重高血糖 (17.24%的死亡率).
- 持续严重的高血糖症 (4组) 是死亡率的独立预测因素 (aOR=3.13).
- 在败血症休克中,缓慢恢复的低血糖 (1组) 和持续的严重高血糖 (4组) 显著增加了死亡风险.
结论:
- GBTM有效地根据血糖轨迹对儿科败血症患者进行分层.
- 持续严重的高血糖是儿科败血症死亡的一个关键风险因素.
- 建议进行表型特定的干预措施,例如高血糖症的胰岛素治疗和低血糖症的葡萄糖输液.
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