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脓毒症休克患者炎症因子表达及病原菌分布情况及其与预后的相关性:一项横断面研究

Expression of inflammatory factors and distribution of pathogens in patients with septic shock and their correlation with prognosis: a cross-sectional study.

作者信息

Chen Jialin, Tan Mengzhu, Xiang Tao

机构信息

The Third People's Hospital of Chengdu, Emergency Department, Chengdu,Sichuan, China.

Chongqing Medical University, The First Affiliated Hospital, Nephrology Department, Yuzhong, Chongqing, China.

出版信息

Rev Inst Med Trop Sao Paulo. 2025 Jul 7;67:e45. doi: 10.1590/S1678-9946202567045. eCollection 2025.

Abstract

This study aimed to investigate the relationship between inflammatory factors, pathogen distribution, and prognosis in patients with septic shock admitted to the emergency department of internal medicine. A total of 140 patients with septic shock admitted to the emergency department of The Third People's Hospital of Chengdu, China, from January 2021 to January 2023 were selected for analysis of the distribution of pathogens and infection sites. Patients were divided into death (36 cases) and survival groups (104 cases) based on their condition after 28 days of treatment. A total of 174 pathogenic bacteria strains were cultured, including 124 Gram-negative bacteria (71.26%) and 43 Gram-positive bacteria (24.71%). The main infection sites were the lungs (33.57%) and the abdominal and gastrointestinal tracts (25.00%). The distribution of pathogens and infection sites in the survival and death groups were compared (P > 0.05). The regression equation predicted patient mortality, with the area under the ROC curve of 0.860 (95% CI: 0.792-0.929; P < 0.05), and sensitivity and specificity of 88.90% and 73.10%, respectively. Pathogen distribution in patients with septic shock in the internal medicine emergency department was not related to prognosis; however, inflammatory factors such as CRP and PCT were predictive of outcomes. Along with age, APACHE II score, and SOFA score, they demonstrated significant prognostic value for patient mortality.

摘要

本研究旨在探讨内科急诊科脓毒症休克患者炎症因子、病原体分布与预后之间的关系。选取2021年1月至2023年1月在中国成都市第三人民医院急诊科收治的140例脓毒症休克患者,分析病原体分布及感染部位。根据治疗28天后的病情,将患者分为死亡组(36例)和存活组(104例)。共培养出174株病原菌,其中革兰阴性菌124株(71.26%),革兰阳性菌43株(24.71%)。主要感染部位为肺部(33.57%)和腹部及胃肠道(25.00%)。比较存活组和死亡组的病原体分布及感染部位(P>0.05)。回归方程预测患者死亡率,ROC曲线下面积为0.860(95%CI:0.792 - 0.929;P<0.05),敏感性和特异性分别为88.90%和73.10%。内科急诊科脓毒症休克患者的病原体分布与预后无关;然而,CRP和PCT等炎症因子可预测预后。与年龄、APACHE II评分和SOFA评分一起,它们对患者死亡率具有显著的预后价值。

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