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白蛋白输注与急性胰腺炎患者脓毒症风险之间的关联。

Association between albumin infusion and sepsis risk of patients with acute pancreatitis.

作者信息

Zhou Xuan, Jiang Bangyan, You Ningjing, Qian Xinfeng, Han Dong, Sun Wei

机构信息

Department of Emergency, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China.

出版信息

PLoS One. 2025 Aug 7;20(8):e0314738. doi: 10.1371/journal.pone.0314738. eCollection 2025.

DOI:10.1371/journal.pone.0314738
PMID:40773463
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12331126/
Abstract

OBJECTIVE

To investigate whether early administration of serum albumin infusion in the acute pancreatitis (AP) patients admitted to the intensive care unit (ICU) reduces the risk of sepsis.

METHODS

Data were collected from the Medical Information Mart for Intensive Care III and IV databases for this retrospective cohort study. The primary outcome was the occurrence of sepsis in AP patients. We used univariate and multivariate logistic regression models to evaluate the association between albumin infusion and sepsis risk of AP patients. Additional subgroup analysis by stratification to serum albumin were also performed.

RESULTS

The study included 779 patients with AP. They were divided into a sepsis group (83 patients) and a non-sepsis group (696 patients) according to whether they developed sepsis, and the prevalence of sepsis was approximately 10.65%. Multivariate logistic regression model indicated that albumin infusion was associated with decreased risk of sepsis in the AP patients [adjusted odds ratio (OR)=0.37, 95% confidence interval (CI)=0.13-0.88]. Subgroup analysis showed a negative association between the albumin infusion and sepsis risk in the AP patients with serum albumin ≤ 3.5g/L (adjusted OR=0.29, 95%CI = 0.08-0.77).

CONCLUSION

In this study, we found an association between albumin administration and a lower risk of sepsis in AP patients, which persisted after multivariate adjustment. This suggests that albumin infusion may have unique potential benefits for this population.

摘要

目的

探讨在入住重症监护病房(ICU)的急性胰腺炎(AP)患者中早期输注血清白蛋白是否能降低脓毒症风险。

方法

本回顾性队列研究的数据来自重症监护医学信息集市III和IV数据库。主要结局是AP患者发生脓毒症。我们使用单因素和多因素逻辑回归模型评估白蛋白输注与AP患者脓毒症风险之间的关联。还按血清白蛋白分层进行了额外的亚组分析。

结果

该研究纳入了779例AP患者。根据是否发生脓毒症,将他们分为脓毒症组(83例)和非脓毒症组(696例),脓毒症患病率约为10.65%。多因素逻辑回归模型表明,白蛋白输注与AP患者脓毒症风险降低相关[调整后的优势比(OR)=0.37,95%置信区间(CI)=0.13 - 0.88]。亚组分析显示,在血清白蛋白≤3.5g/L的AP患者中,白蛋白输注与脓毒症风险呈负相关(调整后的OR = 0.29,95%CI = 0.08 - 0.77)。

结论

在本研究中,我们发现白蛋白给药与AP患者较低的脓毒症风险之间存在关联,多因素调整后该关联仍然存在。这表明白蛋白输注可能对该人群具有独特的潜在益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc4f/12331126/cb738c7c6f84/pone.0314738.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc4f/12331126/cb738c7c6f84/pone.0314738.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc4f/12331126/cb738c7c6f84/pone.0314738.g001.jpg

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Construction and validation of machine learning models for sepsis prediction in patients with acute pancreatitis.构建并验证用于预测急性胰腺炎患者脓毒症的机器学习模型。
BMC Surg. 2023 Sep 1;23(1):267. doi: 10.1186/s12893-023-02151-y.
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Albumin infusion may decrease the mortality of hypoalbuminemia patients with severe acute pancreatitis: a retrospective cohort study.
白蛋白输注可能降低低白蛋白血症重症急性胰腺炎患者的死亡率:一项回顾性队列研究。
BMC Gastroenterol. 2023 Jun 5;23(1):195. doi: 10.1186/s12876-023-02801-8.
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Amphipathic Liponecrosis Impairs Bacterial Clearance and Causes Infection During Sterile Inflammation.两亲性脂肪坏死会损害细菌清除并在无菌性炎症期间导致感染。
Gastroenterology. 2023 Oct;165(4):999-1015. doi: 10.1053/j.gastro.2023.05.034. Epub 2023 May 30.
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