关键词: 脓毒症, 肝损伤, 感染性休克, 多器官功能衰竭, 影响因素

Abstract: Objective The aim of this study was to investigate clinical feature and risk factors of sepsis-related liver injury (SRLI). Methods A total of 175 patients with sepsis were enrolled in this studybetween January 2021 and April 2024, and out of them, 32 patients were found having SRLI. Patients were treated with antibiotics and/or liver-protecting medicines. Serum C-reactive protein (CRP), interleukin-6 (IL-6) and procalcitonin (PCT) levels were assayed by ELISA. Multivariate Logistic regression analysis was applied to reveal risk factors.Results Concomitant diabetes, chronic nephropathy, mechanical ventilation, respiratory and biliary tract infection, SOFA and APACHE Ⅱ scores, positive blood bacteria culture, septic shock and multi-organ functional failure (MOFF) in patients with SRLI were all significantly higher than in those without liver injury (P<0.05); serum ALT, AST, total bilirubin, CRP, IL-6 and PCT levels in patients with SRLI were (92.5±9.7)U/L, (87.5±9.9)U/L, 31.4(17.9, 56.2)μmol/L, (56.3±12.6)mg/L, 130.2(95.2, 162.3)pg/L and 23.6(11.9, 35.0)μg/L, all much higher than [(36.2±3.5)U/L, (31.5±2.9)U/L, 14.0(9.3, 22.4)μmol/L, (9.7±1.7)mg/L, 102.4(74.2, 139.7)pg/L and 11.0(7.7, 17.9)μg/L, respectively, P<0.05], while peripheral platelet count and serum albumin level were 59.1(46.2, 83.4)×10⁹/L and (30.4±2.8)g/L, both significantly lower than [95.6(60.3, 141.8)×10⁹/L and (33.6±2.5)g/L, respectively, P<0.05] in those without liver injury; multivariate Logistic regression analysis showed that serum IL-6 level, septic shock and MOFF were all the risk factors for occurrence of liver injury (all P<0.05). Conclusion SRLI could occur in patients with sepsis, especially in those with septic shock and MOFF, which might be related to inflammatory reactions, and early active antimicrobial therapy is essential in reducing liver injury.

Key words: Sepsis-related liver injury, Septic shock, Multi-organ functional failure, Risk factors