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脓毒症中影响深静脉血栓形成的因素。

Factors influencing DVT formation in sepsis.

作者信息

Wang Lu, Ma Xudong, Chen Yujie, Gao Sifa, Pan Wei, Chen Jieqing, Su Longxiang, He Huaiwu, Long Yun, Yin Chang, Zhou Xiang

机构信息

Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China.

Department of Medical Administration, National Health Commission of the People's Republic of China, Beijing, 100044, China.

出版信息

Thromb J. 2024 Jan 16;22(1):11. doi: 10.1186/s12959-024-00582-y.

Abstract

INTRODUCTION

Sepsis is a global public health burden. Deep vein thrombosis (DVT) is the third most common cause of death from cardiovascular disease after heart attacks and strokes. We designed this experiment to investigate the factors influencing DVT formation in patients with sepsis.

METHODS

In this survey, 918 septic patients admitted to Peking Union Medical College Hospital, who underwent DVT screening were enrolled. The data were collected from June 8, 2013 to October 12, 2022. The differences between septic patients with and without DVT were studied from following aspects: basic information, comorbidities, inflammatory cytokines, albumin, source of infection, sequential organ failure assessment (SOFA) score, coagulation and prognosis.

MAIN RESULTS

In this study, the prevalence of DVT in patients with sepsis was 0.23. Elderly patients with sepsis were prone to DVT (p value < 0.001). In terms of comorbidities, septic patients with hypertension and atrial fibrillation were prone to DVT (p value 0.045 and 0.048). Inflammatory cytokines, such as procalcitonin (PCT), C-reactive protein (CRP), interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor (TNF)-α, had no significant correlation with DVT in patients with sepsis (p value 0.364, 0.882, 0.912, 0.789, 0.245, and 0.780). Levels of serum albumin correlated with DVT in patients with sepsis (p value 0.003). The SOFA total score had no relationship with DVT formation (p value 0.254). Coagulation and respiration function were negatively correlated with DVT (p value 0.018). Liver function was positively correlated with DVT (p value 0.020). Patients in the DVT group had longer duration of mechanical ventilation and longer intensive care unit (ICU) stays (p value < 0.001 and 0.006). There was no significant difference in survival in septic patients with and without DVT (p value 0.868).

CONCLUSIONS

The SOFA total score had no relationship with DVT formation. The function of each organ had different effects on DVT formation. Better coagulation and respiration function, easier DVT formation. Poorer liver function, easier DVT formation. DVT was associated with longer duration of mechanical ventilation and longer ICU stays.

摘要

引言

脓毒症是一项全球公共卫生负担。深静脉血栓形成(DVT)是继心脏病发作和中风之后心血管疾病死亡的第三大常见原因。我们设计了本实验以研究影响脓毒症患者DVT形成的因素。

方法

在本次调查中,纳入了918名在北京协和医院住院并接受DVT筛查的脓毒症患者。数据收集时间为2013年6月8日至2022年10月12日。从以下方面研究有和没有DVT的脓毒症患者之间的差异:基本信息、合并症、炎性细胞因子、白蛋白、感染源、序贯器官衰竭评估(SOFA)评分、凝血和预后。

主要结果

在本研究中,脓毒症患者中DVT的患病率为0.23。老年脓毒症患者易发生DVT(p值<0.001)。在合并症方面,患有高血压和心房颤动的脓毒症患者易发生DVT(p值分别为0.045和0.048)。炎性细胞因子,如降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素(IL)-6、IL-8、IL-10、肿瘤坏死因子(TNF)-α,与脓毒症患者的DVT无显著相关性(p值分别为0.364、0.882、0.912、0.789、0.245和0.780)。脓毒症患者血清白蛋白水平与DVT相关(p值0.003)。SOFA总分与DVT形成无关(p值0.254)。凝血和呼吸功能与DVT呈负相关(p值0.018)。肝功能与DVT呈正相关(p值0.020)。DVT组患者机械通气时间和重症监护病房(ICU)住院时间更长(p值分别<0.001和0.006)。有和没有DVT的脓毒症患者的生存率无显著差异(p值0.868)。

结论

SOFA总分与DVT形成无关。各器官功能对DVT形成有不同影响。凝血和呼吸功能越好,越易形成DVT。肝功能越差,越易形成DVT。DVT与机械通气时间延长和ICU住院时间延长有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3455/10790559/4fd5781ba553/12959_2024_582_Fig1_HTML.jpg

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