急诊科感染性休克患者不同病因下毛细血管血乳酸和血清乳酸水平的变化
Variations in capillary and serum lactates levels based on different etiologies of septic patients in the emergency department.
作者信息
Guarino Matteo, Perna Benedetta, Maroncelli Giacomo, Baldin Paolo, Donati Chiara, Luppi Francesco, Cesaro Alice Eleonora, Pesci Chiara, Costanzini Anna, Maritati Martina, Clavenzani Paolo, Contini Carlo, De Giorgio Roberto, Spampinato Michele Domenico
机构信息
Department of Translational Medicine, St. Anna University Hospital of Ferrara, University of Ferrara, Ferrara, Italy.
Department of Emergency, St. Anna University Hospital of Ferrara, Ferrara, Italy.
出版信息
Front Med (Lausanne). 2025 Apr 16;12:1536148. doi: 10.3389/fmed.2025.1536148. eCollection 2025.
INTRODUCTION
Sepsis is a life-threating and time-depending condition. This study examined the association between sepsis etiology and variations in capillary and serum lactate levels, neutrophil-to-lymphocyte ratio, and diastolic shock index in emergency department patients.
METHODS
This study, conducted between 2021 and 2022 at the Emergency Department of Ferrara, included the following criteria: (i) clinical suspect of infectious disease; (ii) qSOFA ≥2; (iii) age ≥18 years; (iv) signed informed consent. Etiologies were: (i) negative cultures (NC); (ii) Gram positive (GP); (iii) Gram negative (GN); (iv) fungal infections (FI).
RESULTS
Among the 200 included patients, 104 (52.0%) had NC, 36 (18.0%) GP, 53 (26.5%) GN and 7 (3.5%) FI. CLs ( = 0.006) and SLs ( < 0.001) were different according to etiology being higher in GP infections. NLR ( = 0.035) was higher in GN infections, while DSI ( = 0.008) increased in FI. Mortality was not influenced by the etiology.
CONCLUSION
All parameters differed according to sepsis etiology, thus improving early prediction of sepsis etiology and its pharmacological management.
引言
脓毒症是一种危及生命且时间紧迫的病症。本研究调查了急诊科患者中脓毒症病因与毛细血管和血清乳酸水平、中性粒细胞与淋巴细胞比值以及舒张期休克指数变化之间的关联。
方法
本研究于2021年至2022年在费拉拉急诊科进行，纳入标准如下：（i）临床怀疑为传染病；（ii）快速序贯器官衰竭评估（qSOFA）≥2；（iii）年龄≥18岁；（iv）签署知情同意书。病因包括：（i）培养结果为阴性（NC）；（ii）革兰氏阳性菌（GP）；（iii）革兰氏阴性菌（GN）；（iv）真菌感染（FI）。
结果
在纳入的200例患者中，104例（52.0%）为培养结果阴性，36例（18.0%）为革兰氏阳性菌感染，53例（26.5%）为革兰氏阴性菌感染，7例（3.5%）为真菌感染。根据病因不同，毛细血管乳酸水平（P = 0.006）和血清乳酸水平（P < 0.001）有所差异，在革兰氏阳性菌感染中更高。中性粒细胞与淋巴细胞比值（P = 0.035）在革兰氏阴性菌感染中更高，而舒张期休克指数（P = 0.008）在真菌感染中升高。死亡率不受病因影响。
结论
所有参数均因脓毒症病因不同而有所差异，从而改善了脓毒症病因的早期预测及其药物治疗。
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