细菌性败血症和SARS-CoV-2感染中的淋巴衰竭
Raluca Terteşş1,2, Lucian Cristian Petcu2, Bogdan Florentin Niţu1,2
1Clinical Hospital of Infectious Diseases Constanţa, Ferdinand Blvd. No. 100, 900709 Constanta, Romania.
Biomedicines
|February 27, 2026
概括
败血症引起的淋巴缺血和中性粒细胞与淋巴细胞比率 (NLR) 的动态预测了患者的结果. 与细菌性败血症相比,像COVID-19一样的病毒性败血症显示出明显的淋巴细胞计数变化,影响死亡风险.
科学领域:
- 关键护理医学 关键护理医学
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 败血症是一种危及生命的器官功能障碍,原因是对感染的免疫反应过度.
- 败血症引起的淋巴缺血症越来越被认为是关键的预后因素,与二次感染,器官衰竭和死亡等更糟糕的结果有关.
- 有限的研究比较淋巴细胞计数动态跨败血症病因或使用序列测量预后.
研究的目的:
- 在严重的系统性感染中调查淋巴缺血和中性粒细胞与淋巴细胞比率 (NLR) 的时间动态.
- 评估这些动态和住院死亡率之间的关系.
- 为了比较不同传染病病因之间的这些趋势.
主要方法:
- 对95名患有严重系统性感染的成年患者进行前性队列研究.
- 在第1,3,5和第7天记录绝对淋巴细胞计数 (ALC) 和NLR.
- 感染病因和结果之间的比较值;用于ROC分析以预测性能.
主要成果:
- 与细菌性败血症患者不同,病毒性败血症 (COVID-19) 患者的淋巴细胞数量显著持续下降,NLR逐渐增加.
- 从第3天开始,非幸存者的淋巴细胞数量显著下降,NLR在第7天显著上升,无论病因如何.
- 早期的ALC和NLR显示出有限的预测价值,但纵向趋势与预后不佳相关.
结论:
- 淋巴细胞计数和NLR的长度监测提供了在败血症中宝贵的预后信息.
- 在病毒性和细菌性败血症之间存在明显的淋巴缺血和NLR时间模式.
- 持续的淋巴缺血和升高的NLR与败血症患者的住院死亡率增加有关.
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