重症儿童的次要肝功能障碍:超越PRISM III和PELOD-2得分的预后关联
Tuğba Gürsoy Koca1, Abdulkerim Elmas2, Ümüt Altuğ3
1Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Faculty of Medicine, Pamukkale University, Denizli 20160, Turkey.
Journal of clinical medicine
|February 13, 2026
概括
二次性肝功能障碍在重症儿童中很常见,影响8.8%的患者. 这种情况与更糟糕的结果和长时间停留在儿科重症监护室有关,这表明需要定期进行肝脏评估.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 肝病学 肝病学是一种肝病学.
- 临床结果研究研究
背景情况:
- 二次性肝功能障碍是重症儿童的常见并发症,通常源于诸如败血症和多器官功能障碍等系统性问题.
- 它经常被忽视,并且与主要肝脏疾病不同.
- 了解其发生率和影响对于有效的患者管理至关重要.
研究的目的:
- 确定儿科重症监护室 (PICU) 队列中二次性肝功能障碍的发生率和临床特征.
- 评估这种疾病的预后意义,包括其与PRISM III和PELOD-2等严重程度得分的关系.
- 评估肝功能障碍与死亡率和长时间PICU停留等结果之间的关联.
主要方法:
- 在2022年1月至2024年12月期间,对567例儿科重症监护病房住院病人的回顾性分析.
- 排除患有先前存在的肝病或急性肝衰竭的患者.
- 基于年龄调整的高生物化学标志物的肝功能障碍的定义;对人口统计,临床,实验室数据和结果的分析.
主要成果:
- 在PICU入院的8.8% (50名患者) 中,发现了二次肝功能障碍.
- 肝细胞损伤是主要的模式 (96%).
- 死亡率为22%,与败血症,机械通风和无otropic 支持有显著的关联;PRISM III和PELOD-2得分在未幸存者中更高. 具体的肝酶升高并不能独立预测死亡率.
结论:
- 二次性肝功能障碍是重症儿童的常见并发症,与包括长时间PICU停留在内的不良结果有关.
- 肝功能障碍的预后相关性可能超出当前的严重程度得分,特别是在发病率方面.
- 在PICU中进行例行肝脏评估可能有助于早期风险分层和管理.
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