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目的 旨在探究脓毒症发生肝损伤的危险因素，为脓毒症肝损伤患者的诊疗提供参考。方法 回顾性分析402例脓毒症患者的临床数据，依据患者入住ICU期间急性肝损伤发生情况，将观察对象分为脓毒症肝损伤组与脓毒症非肝损伤组。通过单因素分析筛选与肝损伤发生潜在关联的临床指标，再构建多因素Logistic回归模型，确定影响脓毒症患者发生肝损伤的独立危险因素。结果 共收集符合标准的脓毒症患者229例，合并肝损伤患者110例(48.03%)，其中肝损伤组死亡52例(47.27%)。脓毒症肝损伤组与脓毒症非肝损伤组分析比较：APACHEⅡ评分、SOFA评分、血小板、乳酸、纤维蛋白原含量、糖尿病、腹腔感染、血管活性药物治疗、连续性肾脏替代治疗、机械通气治疗差异有统计学意义(P<0.05)。纳入多因素Logistic中分析结果显示：SOFA评分(OR=1.19, 95%CI:1.06～1.33)、糖尿病(OR=3.27, 95%CI:1.65～6.48)、腹腔感染(OR=2.74,95%CI:1.33～5.62)和机械通气(OR=5.24, 95%CI:1.58～17.41)为脓毒症患者发生肝损伤的独立危险因素。结论 糖尿病、腹腔感染、SOFA评分和机械通气治疗是脓毒症患者发生肝损伤的独立危险因素。
Abstract：Objective To explore the risk factors for liver injury in sepsis, so as to provide a reference for the diagnosis and treatment of sepsis patients with liver injury.Methods A retrospective analysis was conducted on the clinical data of 402 patients with sepsis. According to the occurrence of acute liver injury during ICU stay, the patients were divided into a sepsis with liver injury group and a sepsis without liver injury group. Univariate analysis was used to screen clinical indicators potentially associated with liver injury, and a multivariate Logistic regression model was then established to identify the independent risk factors for acute liver injury in sepsis patients.Results A total of 229 sepsis patients who met the inclusion criteria were enrolled, among whom 110 cases(48. 03%) had liver injury, and 52 patients(47. 27%) in the liver injury group died. There were statistically significant differences between the two groups in APACHE Ⅱ score, SOFA score, platelet count, lactate level, fibrinogen content, diabetes mellitus, abdominal infection, vasoactive drug therapy, continuous renal replacement therapy, and mechanical ventilation therapy(P<0. 05). Multivariate Logistic regression analysis showed that SOFA score(OR=1. 19, 95%CI: 1. 06-1. 33), diabetes mellitus(OR=3. 27, 95%CI: 1. 65-6. 48), abdominal infection(OR=2. 74, 95%CI: 1. 33-5. 62), and mechanical ventilation therapy(OR=5. 24, 95%CI: 1. 58-17. 41) were independent risk factors.Conclusion Diabetes, mellitus, abdominal infection, SOFA score, and mechanical ventilation therapy are independent risk factors for acute liver injury in sepsis patients.
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基本信息:
DOI：10.19405/j.cnki.issn1000-1492.2026.07.022
中图分类号:R459.7;R575
引用信息:
[1]许伦兵,季强,邵敏.脓毒症相关急性肝损伤的临床特点及高危因素[J].安徽医科大学学报,2026,61(07):1318-1324.DOI:10.19405/j.cnki.issn1000-1492.2026.07.022.
基金信息:
国家自然科学基金项目(编号：82370605)~~
2026-05-14
2026-05-14
2026-05-14