酸过量作为败血症相关急性损伤的早期预测因素:一项前性观察性研究
Tatikonda Chandra Mouli1, Satyajit Choudhury2, Pritam Chhotray3
1Dept of Critical Care Medicine, RACC ICU, Rajahmundry, Andhra Pradesh, India.
European journal of medical research
|December 30, 2025
概括
基线基过量 (ABE) 有效预测24小时内败血症相关的急性损伤 (SA-AKI) 风险. 这种易于测量的生物标志物有助于早期风险分层,并改善了败血症患者的治疗结果.
科学领域:
- 临界护理医学 临界护理医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 生物标志物 生物标志物
背景情况:
- 败血症相关的急性损伤 (SA-AKI) 在重症患者中显著增加了发病率和死亡率.
- 早期识别和干预对于改善患者的治疗结果至关重要.
- 这项研究评估了乳酸基过量 (ABE) 作为SA-AKI的早期预测生物标志物.
研究的目的:
- 调查乳酸基过剩 (ABE) 对SA-AKI在入院后的前24小时内发展的预测值.
- 评估基线ABE和SA-AKI发病率,严重程度和住院死亡率之间的相关性.
- 为了确定不同时间点 (0,12小时和24小时) 的ABE测量的实用性,用于SA-AKI预测.
主要方法:
- 一项前性观察性研究,涉及印度东部369名成年败血症患者.
- 亚拉克基过量 (ABE) 被计算在服用后的0,12和24小时.
- 急性损伤 (AKI) 诊断遵循KDIGO标准;二级结局包括AKI严重程度和死亡率.
主要成果:
- 159名患者 (43%) 患有AKI,66名患者 (17.9%) 需要替代疗法 (RRT).
- 基线ABE是SA-AKI的独立预测因子;每增加1mmol/L的ABE将AKI风险降低11% (aOR0.89,p=0.030).
- 更多的负面基线ABE值与更高的AKI发病率和死亡率相关;12小时和24小时的ABE测量不是独立的预测.
结论:
- 基线ABE是一种具有成本效益,可访问的生物标志物,用于预测SA-AKI和住院死亡率.
- 早期的ABE评估可以增强风险分层,并可能改善败血症管理的结果,特别是在资源有限的环境中.
- 建议对基线ABE进行多中心验证,以预测SA-AKI.
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