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较高的血清皮质醇与感染性休克患者的延迟休克分辨率有关
Sophon Dumrongsukit1, Suranut Charoensri2, Kamonwan Mulalin1
1Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Journal of intensive care medicine
|February 18, 2026
概括
性休克患者血清皮质醇水平升高预测休克逆转速度较慢,早期休克控制减少. 然而,在这项研究中,高皮质醇与28天死亡率的增加没有联系.
科学领域:
- 关键护理医学 关键护理医学
- 内分泌学 在内分泌学.
- 败血症研究 败血症研究
背景情况:
- 血清皮质醇升高与性休克死亡率有关.
- 皮质醇和败血性休克的血液动力恢复之间的关系需要进一步调查.
研究的目的:
- 调查初始血清皮质醇水平与血液动力学恢复之间的关联,特别是冲击逆转,在成年患有败血性冲击的患者中.
主要方法:
- 一项前性队列研究,涉及81名成年败血症休克患者.
- 在诊断时测量了血清皮质醇,SOFA和APACHE III分数.
- 冲击逆转被定义为停止血管压缩剂治疗24小时,MAP≥65mmHg.
主要成果:
- 较高的血清皮质醇水平独立预测了72小时后冲击逆转的可能性较低 (HR每1μg/dL增加:0.95).
- 皮质醇升高与6小时早期冲击控制的可能性降低有关 (HR:0.96).
- 皮质醇水平> 30μg/dL显示72小时冲击逆转的概率大大降低 (HR:0.17).
结论:
- 在败血症休克中初始升高的血清皮质醇水平独立地预测延迟的休克逆转和较差的早期休克控制.
- 在皮质醇升高和28天死亡率之间没有发现显著的关联.
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