非肝性血清氨水平与脓毒症相关性脑病的关系:一项回顾性队列研究。

IF 1.2 4区 医学 Q3 EMERGENCY MEDICINE
Emergency Medicine International Pub Date : 2023-10-12 eCollection Date: 2023-01-01 DOI:10.1155/2023/6676033
Pei Wang, Jia Yan, Qiqing Shi, Fei Yang, Xuguang Li, Yuehao Shen, Haiying Liu, Keliang Xie, Lina Zhao
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引用次数: 0

摘要

目的:败血症患者常发生非肝性高氨血症。氨在肝性脑病的发生中起着重要作用。然而,非肝性血清氨水平与败血症相关性脑病(SAE)之间的关系尚不清楚。因此,我们旨在评估血清氨水平与SAE患者之间的关系。方法:从2008年至2019年重症监护IV医疗信息集市(MIMIC IV)中检索入住重症监护室的败血症危重成人的数据,并进行回顾性分析。没有包括败血症患者和与急性或慢性肝病无关的血清氨的数据。结果:纳入720例败血症患者的数据。SAE的发病率很高(64.6%)。在对其他风险因素进行调整后,血清氨水平≥45 μmol/L(比值比(OR):3.508,95%可信区间(CI):2.336-5.269,p<0.001)是SAE患者的独立危险因素;此外,随着血清氨水平的升高,SAE的住院死亡率在一定范围内(血清氨μmol/L)逐渐升高。血清氨水平≥45 μmol/L与SAE患者更高的简化急性生理学评分II和顺序器官衰竭评估(SOFA)评分相关。此外,我们的研究发现,SAE患者使用阿片类止痛药(OR:3.433,95%CI:1.360-8.669,p=0.009),SAE患者的SOFA评分(OR:1.126,95%CI:1.062-1.194,p<0.001)显著高于非SAE患者 μmol/L可明显增加SAE的发生率。败血症患者应密切监测血清氨水平。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Relationship between Nonhepatic Serum Ammonia Levels and Sepsis-Associated Encephalopathy: A Retrospective Cohort Study.

Relationship between Nonhepatic Serum Ammonia Levels and Sepsis-Associated Encephalopathy: A Retrospective Cohort Study.

Relationship between Nonhepatic Serum Ammonia Levels and Sepsis-Associated Encephalopathy: A Retrospective Cohort Study.

Relationship between Nonhepatic Serum Ammonia Levels and Sepsis-Associated Encephalopathy: A Retrospective Cohort Study.

Objectives: Nonhepatic hyperammonemia often occurs in patients with sepsis. Ammonia plays an essential role in the occurrence of hepatic encephalopathy. However, the relationship between nonhepatic serum ammonia levels and sepsis-associated encephalopathy (SAE) remains unclear. Thus, we aimed to evaluate the association between serum ammonia levels and patients with SAE.

Methods: Data of critically ill adults with sepsis who were admitted to the intensive care unit were retrieved from the Medical Information Mart for Intensive Care IV (MIMIC IV) between 2008 and 2019 and retrospectively analyzed. Data of patients with sepsis patients and serum ammonia not related to acute or chronic liver disease were not included.

Results: Data from 720 patients with sepsis were included. SAE was found to have a high incidence (64.6%). After adjusting for other risk factors, a serum ammonia level of ≥45 μmol/L (odds ratio (OR): 3.508, 95% confidence interval (CI): 2.336-5.269, p < 0.001) was found to be an independent risk factor for patients with SAE; moreover, as the serum ammonia level increased, the hospital mortality of SAE gradually increased in a certain range (serum ammonia <150 μmol/L). Serum ammonia levels of ≥45 μmol/L were associated with higher Simplified Acute Physiology Score II and Sequential Organ Failure Assessment (SOFA) scores in patients with SAE. Besides, our study found that patients with SAE used opioid analgesics (OR:3.433, 95% CI: 1.360-8.669, p = 0.009) and the SOFA scores of patients with SAE (OR: 1.126, 95% CI: 1.062-1.194, p < 0.001) were significantly higher than those without SAE.

Conclusions: Nonhepatic serum ammonia levels of ≥45 μmol/L evidently increased the incidence of SAE. Serum ammonia levels should be closely monitored in patients with sepsis.

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来源期刊
Emergency Medicine International
Emergency Medicine International EMERGENCY MEDICINE-
CiteScore
0.10
自引率
0.00%
发文量
187
审稿时长
17 weeks
期刊介绍: Emergency Medicine International is a peer-reviewed, Open Access journal that provides a forum for doctors, nurses, paramedics and ambulance staff. The journal publishes original research articles, review articles, and clinical studies related to prehospital care, disaster preparedness and response, acute medical and paediatric emergencies, critical care, sports medicine, wound care, and toxicology.
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