抗血素水平与败血症患者的预后之间的关联:基于MIMIC-IV和MIMIC-III数据库的回顾性队列研究
Bingkui Ren1, Gang Zhou1, Haiyan Xue1
1Department of Intensive Care Medicine, Peking University People's Hospital, No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, People's Republic of China.
Journal of intensive care
|February 3, 2026
概括
败血症患者的低抗素 (AT) 活性与增加的死亡率和器官功能障碍有关. 确定AT活动值,比如总体55%,高血压患者64%,有助于风险分层.
科学领域:
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
- 药理学 药理学是指药理学的学科.
背景情况:
- 败血症显著增加了重症患者的死亡率.
- 抗凝血素 (AT) 具有抗凝血和抗炎性质,但其在败血症中的预后作用尚不清楚.
- 这项研究调查了AT活动与败血症结果的关联,并确定了预后值.
研究的目的:
- 确定抗血素 (AT) 活性水平与败血症患者的临床结果之间的关系.
- 确定特定的AT活动值,预测死亡率和器官功能障碍.
- 探索AT活性对于败血症风险分层的预后价值.
主要方法:
- 来自MIMIC-IV和MIMIC-III数据库的222名败血症患者的回顾性队列研究.
- 在败血症诊断后24小时内测量AT活性;主要结局是28天全因死亡率.
- 限制立方线 (RCS) 用于建模剂量反应关系并确定风险值,使用多变量考克斯回归进行调整.
主要成果:
- 发现AT活性与28天死亡率之间存在非线性关联,在整体队列中,AT活性低于~55%的风险增加.
- 具有AT活性<55%的患者的28天死亡率,ICU死亡率,以及传播性血管内凝血 (DIC) 和急性损伤 (AKI) 的发病率显著更高.
- 观察到与高血压的显著相互作用;高血压患者的AT活性低于~64%的风险增加,死亡率和DIC率明显较高.
结论:
- 减少AT活性是败血症增加的死亡率和器官功能障碍的重要预测因素.
- 鉴于AT活动的预后值约为55% (总体) 和64% (高血压患者).
- 这些发现表明,AT活动可以作为败血症风险分层的预后生物标志物,并可能指导管理策略.
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