脓毒症并发急性肝损伤患者危险因素分析*

doi:10.3969/j.issn.1672-5069.2025.05.022

摘要/Abstract

摘要： 目的分析脓毒症患者并发急性肝损伤的危险因素。方法 2021年8月～2024年8月我院收治的207例脓毒症患者,其中并发急性肝损伤者107例。给予抗感染和生命支持治疗,给予肝损伤患者护肝治疗。常规检测C-反应蛋白(CRP)、降钙素原(PCT)、D-二聚体(D-D)水平。应用多因素Logistic回顾分析影响脓毒症并发急性肝损伤的危险因素。结果肝损伤组血小板计数和血清ALB水平分别为(123.6±26.0)×10⁹/L和(29.9±5.4)g/L,均显著低于脓毒症未并发肝损伤组【分别为(170.4±30.3)×10⁹/L和(32.9±6.0)g/L,P＜0.05】,而血清CRP、D-D、APACHE Ⅱ评分、ICU入住时间、机械通气时间和抗生素应用时间分别为(90.9±18.7)mg/L、(4.1±0.8)μg/ml、(21.5±3.5)、(11.3±1.5)d、(130.5±13.1)h和(14.4±2.8)d,均显著高于或长于脓毒症组【分别为(46.9±8.3)mg/L、(2.3±0.5)μg/ml、(16.7±3.4)、(4.8±1.0)d、(45.4±4.8)h和(7.3±1.2)d,P＜0.05】;经多因素Logistic回归分析,结果显示入住ICU时间、机械通气、抗生素应用时间和APACHE Ⅱ评分均是导致脓毒症患者并发急性肝损伤的危险因素(P<0.05)。结论一些脓毒症患者可能并发急性肝损伤,了解这些危险因素并给予积极的防治,可能改善预后。

关键词: 急性肝损伤, 脓毒症, 危险因素, 预后

Abstract: Objective The aim of this study was to investigate risk factors of acute liver injury (ALI) in patients with sepsis. Methods 207 patients with sepsis were encountered in our hospital between August 2021 and August 2024, and out of them, ALI was found in 107 cases according to diagnostic criteria. All patients received antibiotics and life-supporting therapy, and those with ALI were carefully dealt with liver-supporting approaches. Serum C-reaction protein (CRP), procalcitonin (PCT) and D-dimer (D-D) levels were determined by fluorescent immunochromatography. Multivariate Logistics regression analysis was applied to analyze the risk factors for ALI occurrence. Results Platelet count and serum albumin level in patients with ALI were (123.6±26.0)×10⁹/L and (29.9±5.4)g/L, both significantly lower than [(170.4±30.3)×10⁹/L and (32.9±6.0)g/L, respectively, P＜0.05], while serum CRP, D-D, APACHE Ⅱ score, ICU stay, mechanical ventilation and intravenous administration of antibiotics were (90.9±18.7)mg/L, (4.1±0.8)μg/ml, (21.5±3.5)points, (11.3±1.5)d, (130.5±13.1)h and (14.4±2.8)d, all significantly higher or longer than [(46.9±8.3)mg/L, (2.3±0.5)μg/ml, (16.7±3.4), (4.8±1.0)d, (45.4±4.8)h and (7.3±1.2)d, respectively, P＜0.05] in patients with sepsis without ALI; multivariate Logistic regression analysis showed that ICU stay, mechanical ventilation, intravenous administration of antibiotics and APACHE Ⅱ score were all the independent risk factors for occurrence of ALI in patients with sepsis(P<0.05). Conclusion The patients with sepsis could be complicated with ALI, and acknowledge of them and giving an early prevention and treatment might improve prognosis of them.

Key words: Acute liver injury, Sepsis, Risk factors, Prognosis

鞠敏, 杨巍, 丁小山, 何小卫. 脓毒症并发急性肝损伤患者危险因素分析^*[J]. 实用肝脏病杂志, 2025, 28(5): 727-730.

Ju Min, Yang Wei, Ding Xiaoshan, et al. Risk factors of acute liver injury in patients with sepsis: An analysis of 107 cases[J]. Journal of Practical Hepatology, 2025, 28(5): 727-730.

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脓毒症并发急性肝损伤患者危险因素分析^*

Risk factors of acute liver injury in patients with sepsis: An analysis of 107 cases

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