Liu Yu-Fei, Cong Wen, Zhou Chang-Ming, Yu Yang, Zhang Xin-Jie
Department of Emergency Critical Care Medicine, The Second Hospital of Dalian Medical University, Dalian 116027, Liaoning Province, China.
Department of Psychiatry, Dalian Seventh People's Hospital (Dalian Mental Health Center), Dalian 116023, Liaoning Province, China.
World J Psychiatry. 2025 Apr 19;15(4):102763. doi: 10.5498/wjp.v15.i4.102763.
The central link between septic shock and acute skin failure (ASF) is the inflammatory response, which occurs throughout disease progression and can lead to systemic inflammatory response syndrome. Patients often experience bad moods, sleep disorders, and other health issues. Despite recognizing these factors, no studies have examined the correlation between inflammatory factors, lactic acid levels, ASF, mood disturbances, and sleep quality in critically ill patients. We hypothesize that higher levels of inflammatory factors and lactic acid are associated with more severe ASF and poorer mood and sleep quality, which may inform clinical treatment for septic shock and ASF.
To explore the relationship between inflammatory factors, lactic acid levels, the severity of ASF, bad mood, and sleep quality.
The retrospective study included 150 patients with septic shock from the Second Hospital of Dalian Medical University, categorized into ASF ( = 35) or non-ASF groups ( = 115). We compared the peripheral blood inflammatory factors, including tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), interleukin-6 (IL-6), lactic acid levels, skin mottling score (SMS), modified early warning score (MEWS), self-rating depression scale (SDS), self-rating anxiety scale (SAS), and Pittsburgh sleep quality index (PSQI) scores. Pearson correlation analysis assessed relationships among these variables.
The ASF group had significantly higher levels of CRP (19.60 ± 4.10 15.30 ± 2.96 mg/mL), IL-6 (298.65 ± 48.65 268.66 ± 33.66 pg/L), procalcitonin, lactic acid (8.42 ± 2.32 5.70 ± 1.27 mmol/L), SMS [0 (0, 1) 3 (2, 3)], MEWS (9.34 ± 1.92 6.48 ± 1.96), SAS (61.63 ± 12.03 53.71 ± 12.48), SDS (60.17 ± 12.64 52.27 ± 12.64), and PSQI scores (14.23 ± 3.94 8.69 ± 2.46) compared with the non-ASF group (all < 0.001). Pearson correlation analysis revealed that IL-6, CRP, TNF-α, and lactic acid were positively correlated with SMS, MEWS, SAS, SDS, and PSQI scores ( < 0.05).
Peripheral blood levels of IL-6, CRP, TNF-α, and lactic acid correlate positively with SMS, MEWS, SAS, SDS, and PSQI in critically ill patients with ASF.
脓毒性休克与急性皮肤衰竭（ASF）之间的核心联系是炎症反应，该反应贯穿疾病进展过程，并可导致全身炎症反应综合征。患者常出现情绪不佳、睡眠障碍及其他健康问题。尽管认识到这些因素，但尚无研究考察危重症患者炎症因子、乳酸水平、ASF、情绪障碍及睡眠质量之间的相关性。我们推测，较高水平的炎症因子和乳酸与更严重的ASF以及更差的情绪和睡眠质量相关，这可能为脓毒性休克和ASF的临床治疗提供参考。
探讨炎症因子、乳酸水平、ASF严重程度、不良情绪与睡眠质量之间的关系。
这项回顾性研究纳入了大连医科大学附属第二医院的150例脓毒性休克患者，分为ASF组（n = 35）和非ASF组（n = 115）。我们比较了外周血炎症因子，包括肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）、白细胞介素-6（IL-6）、乳酸水平、皮肤花斑评分（SMS）、改良早期预警评分（MEWS）、自评抑郁量表（SDS）、自评焦虑量表（SAS）以及匹兹堡睡眠质量指数（PSQI）评分。采用Pearson相关性分析评估这些变量之间的关系。
与非ASF组相比，ASF组的CRP（19.60±4.10比15.30±2.96 mg/mL）、IL-6（298.65±48.65比268.66±33.66 pg/L）、降钙素原、乳酸（8.42±2.32比5.70±1.27 mmol/L）、SMS[0（0，1）比3（2，3）]、MEWS（9.34±1.92比6.48±1.96）、SAS（61.63±12.03比53.71±12.48）、SDS（60.17±12.64比52.27±12.64）及PSQI评分（14.23±3.94比8.69±2.46）均显著更高（均P < 0.001）。Pearson相关性分析显示，IL-6、CRP、TNF-α及乳酸与SMS、MEWS、SAS、SDS及PSQI评分呈正相关（P < 0.05）。
在患有ASF的危重症患者中，外周血IL-6、CRP、TNF-α及乳酸水平与SMS、MEWS、SAS、SDS及PSQI呈正相关。
