影响脓毒症相关血小板减少症（SAT）的因素：一项多中心回顾性队列研究。
Factors influencing sepsis associated thrombocytopenia (SAT): A multicenter retrospective cohort study.
作者信息
Wang Lu, Chen Jieqing, Zhou Xiang
机构信息
Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Information Center Department/Department of Information Management, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
出版信息
PLoS One. 2025 Feb 10;20(2):e0318887. doi: 10.1371/journal.pone.0318887. eCollection 2025.
INTRODUCTION
Sepsis associated thrombocytopenia (SAT) is a common complication of sepsis. We designed this study to investigate factors influencing SAT.
METHODS
Patients with sepsis (2984 in Peking union medical college hospital [PUMCH] database, 13165 in eICU Collaborative Research [eICU] database, 11101 in Medical Information Mart for Intensive Care IV [MIMIC-IV] database) were enrolled. Variables included basic information, comorbidities, and organ functions. Multi-variable logistic regression models and artificial neural network model were applied to determine the factors related to SAT.
MAIN RESULTS
Age and body mass index (BMI) were inversely correlated with the incidence of SAT (p-value 0.175 and 0.049 [PUMCH], p-value 0.000 and 0.000 [eICU], p-value 0.000 and 0.000 [MIMIC-IV]). Hematologic malignancies and other malignancies were positively correlated with the incidence of SAT (p-value 0.000 and 0.000 [PUMCH], p-value 0.000 and 0.000 [eICU], p-value 0.000 and 0.020 [MIMIC-IV]) except other malignancies was inversely correlated with the incidence of SAT in PUMCH database. Norepinephrine (NE) equivalents, total bilirubin (TBIL) and creatinine were positively correlated with the incidence of SAT (p-value 0.000, 0.000 and 0.011 [PUMCH], p-value 0.028, 0.000 and 0.013 [eICU], p-value 0.028, 0.000 and 0.027 [MIMIC-IV]). PaO2 / FiO2 was inversely correlated with the incidence of SAT in PUMCH database (p-value 0.021 [PUMCH]), while it was positively correlated with the incidence of SAT (p-value 0.000 [MIMIC-IV]). PaO2 / FiO2 and SAT was not related (p-value 0.111 [eICU]). TBIL, hematologic malignancies, PaO2 / FiO2 and NE equivalents ranked in the top five significant variables in all three datasets.
CONCLUSIONS
Hematologic malignancies and other malignancies were positively correlated with the incidence of SAT. NE equivalents, TBIL and creatinine were positively correlated with the incidence of SAT. TBIL, hematologic malignancies, PaO2 / FiO2 and NE equivalents ranked in the top significant variables in factors influencing SAT.
引言
脓毒症相关血小板减少症（SAT）是脓毒症常见的并发症。我们设计本研究以调查影响SAT的因素。
方法
纳入脓毒症患者（北京协和医院[PUMCH]数据库中有2984例，电子重症监护病房协作研究[eICU]数据库中有13165例，重症监护医学信息集市IV[MIMIC-IV]数据库中有11101例）。变量包括基本信息、合并症和器官功能。应用多变量逻辑回归模型和人工神经网络模型来确定与SAT相关的因素。
主要结果
年龄和体重指数（BMI）与SAT的发生率呈负相关（PUMCH数据库中p值分别为0.175和0.049，eICU数据库中p值分别为0.000和0.000，MIMIC-IV数据库中p值分别为0.000和0.000）。血液系统恶性肿瘤和其他恶性肿瘤与SAT的发生率呈正相关（PUMCH数据库中p值分别为0.000和0.000，eICU数据库中p值分别为0.000和0.000，MIMIC-IV数据库中p值分别为0.000和0.020），但在PUMCH数据库中其他恶性肿瘤与SAT的发生率呈负相关。去甲肾上腺素（NE）等效剂量、总胆红素（TBIL）和肌酐与SAT的发生率呈正相关（PUMCH数据库中p值分别为0.000、0.000和0.011，eICU数据库中p值分别为0.028、0.000和0.013，MIMIC-IV数据库中p值分别为0.028、0.000和0.027）。在PUMCH数据库中，动脉血氧分压/吸入氧分数值（PaO2/FiO2）与SAT的发生率呈负相关（p值为0.021[PUMCH]），而在MIMIC-IV数据库中呈正相关（p值为0.000[MIMIC-IV]）。在eICU数据库中，PaO2/FiO2与SAT无关（p值为0.111[eICU]）。在所有三个数据集中，TBIL、血液系统恶性肿瘤、PaO2/FiO2和NE等效剂量在前五个显著变量中。
结论
血液系统恶性肿瘤和其他恶性肿瘤与SAT的发生率呈正相关。NE等效剂量、TBIL和肌酐与SAT的发生率呈正相关。TBIL、血液系统恶性肿瘤、PaO2/FiO2和NE等效剂量在影响SAT的因素中排名前几位显著变量。
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