乳酸与白蛋白比率升高的败血症患者的凝血风险:一个回顾性队列研究
Jiangui Wang1,2, Chaowei Wang1,2, Zhiyuan Zhang1,2
1Department of Critical Care Medicine, The First Affiliated Hospital of Gannan Medical University, Ganzhou, 341000, China.
BMC infectious diseases
|January 24, 2026
概括
败血症患者乳酸与白蛋白比率 (LAR) 升高与败血症诱导的凝血病 (SIC) 和死亡风险增加有关. 这个比率显示出比单独的乳酸或白蛋白更好的预测能力.
科学领域:
- 临界护理医学 临界护理医学
- 生物标志物研究 生物标志物研究
- 败血症病理生理学病理生理学
背景情况:
- 败血症引起的凝血病 (SIC) 是败血症的常见并发症,显著增加死亡风险.
- 了解SIC的预测标志物对于及时干预和改善患者结果至关重要.
研究的目的:
- 调查乳酸与白蛋白比率 (LAR) 与败血症引起的凝血病 (SIC) 的发生率之间的关联.
- 评估LAR对SIC的预测性能及其与败血症患者全因死亡率的相关性.
主要方法:
- 从MIMIC-IV 3.1数据库对8,661名败血症患者的回顾性分析.
- 使用多变量逻辑回归,受限立方支线 (RCS) 分析和ROC曲线分析来评估LAR-SIC关系和预测准确性.
- 使用考克斯回归分析来确定LAR和死亡率之间的关联.
主要成果:
- 在LAR和SIC发病率之间发现了显著的积极关联;较高的LAR水平与发展SIC的几率增加相关 (OR,2.85).
- 与乳酸 (AUC=0.69) 或白蛋白 (AUC=0.61) 相比,LAR显示了SIC (AUC=0.71) 的优异预测性能.
- 升高的LAR独立地与28天和360天全因死亡风险增加有关 (HR,分别为1.15和1.14).
结论:
- 早期乳酸与白蛋白比率 (LAR) 的升高是败血症诱导凝血病 (SIC) 和败血症患者死亡率风险增加的潜在指标.
- 作为SIC的预测生物标志物,LAR显示出有前途的表现,其表现优于个体的乳酸盐和白蛋白水平.
- 需要进一步的前性研究来证实这些发现,并探索LAR在败血症管理中的临床应用.
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