不调节的血清化物和临床结果在重症成年人:一个系统的审查和元分析
Xiaoliang Wan1, Feiyao Deng1, Xue Bai2
1Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
患有高或低血清化物水平的重症患者面临增加的死亡率和急性损伤风险. 监测和管理这些电解质失衡对于更好的患者结果至关重要.
科学领域:
- 关键护理医学 关键护理医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床化学 临床化学
背景情况:
- 不调节的血清化物水平在重症患者中很常见,但其临床意义尚不清楚.
- 现有的研究缺乏对化物水平异常及其对患者结果的影响的全面分析.
研究的目的:
- 在重症患者群体中系统地审查和元分析低血和高血的患病率.
- 调查异常血清化物水平与死亡率和急性损伤 (AKI) 之间的关联.
主要方法:
- 在主要数据库 (PubMed,Embase,Web of Science,Cochrane Library) 进行了系统的文献搜索,搜索到2025年8月之前发表的研究.
- 包括的研究报告了成年ICU患者中高血病的患病率或结果.
- 使用Stata v16.0进行统计分析,使用纽卡斯尔-太华尺度评估研究质量.
主要成果:
- 这项研究包括34项研究,涉及175,021名患者.
- 总的流行率:高血症 (34%),低血症 (14%).
- 高血和低血都与死亡率的增加显著相关 (分别为1.28和1.55).
- 观察到血清化物和死亡率之间的非线性剂量反应关系.
- 超血与AKI的风险增加有关 (OR 1.40).
结论:
- 失调的血清化物是重症患者中普遍存在且具有临床意义的生物标志物.
- 高和低化物水平独立地增加死亡风险.
- 过血症与AKI的风险更高有关,强调需要仔细监测和管理.
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