儿童脓毒性心肌病的临床特征及发病危险因素分析OACSTPCD
Clinical features and risk factors of sepsis-induced cardiomyopathy in children with sepsis
目的 探讨脓毒症儿童合并脓毒性心肌病(SICM)的临床特征及发病危险因素,为提高临床医师的诊治水平提供参考.方法 回顾性分析脓毒症患儿的临床资料.按照是否发生SICM,将其分为SICM组和非SICM组,比较 2 组患儿的临床特点及转归,分析SICM发生的危险因素.结果 ①398 例脓毒症患儿被纳入研究,其SICM发病率为 15.58%(62/398).SICM组年龄[49(18,108)个月]大于非SICM组[19(6,52)个月],SICM组合并脓毒性休克比例[83.87%(52/62)]高于非SICM组[42.56%(143/336)];SICM组病死率[29.03%(18/62)]高于非SICM组[14.58%(49/336)],比较差异均有统计学意义(P<0.05).②多因素Logistic回归分析显示:年长儿发生SICM的风险更高(OR=1.010,95%CI 1.003～1.017,P=0.006);血乳酸水平越高,发生SICM的风险越高(OR=1.163,95%CI 1.034～1.308,P=0.012);肌钙蛋白水平越高,发生SICM风险越高(OR=9.929,95%CI 4.651～21.197,P<0.001).结论 与非SICM患儿相比,SICM患儿更易发生脓毒性休克,病死率更高.年龄、乳酸及cTnI为儿童SICM独立的影响因素.
Objective To investigate the clinical features and risk factors of sepsis-induced cardiomyopathy in children with sepsis,aiming to provide reference for enhancing the diagnosis and treatment levels of clinicians.Methods Clinical data of children with sepsis were retrospectively analyzed.All patients were divided into the sepsis-induced cardiomyopathy group and non-sepsis-induced cardiomyopathy group according to whether sepsis-induced cardiomyopathy occurred.Clinical characteristics and outcomes were compared between two groups.The risk factors of sepsis-induced cardiomyopathy were analyzed.Results Three hundred and ninty-eight children with sepsis were included in this study,and the incidence of sepsis-induced cardiomyopathy was 15.58%(62/398).The age of children in the sepsis-induced cardiomyopathy group was 49(18,108)months,older than 19(6,52)months in the non-sepsis-induced cardiomyopathy group.The incidence of septic shock in the sepsis-induced cardiomyopathy group was 83.87%(52/62),which was higher than 42.56%(143/336)in the non-sepsis-induced cardiomyopathy group.The mortality rate in the sepsis-induced cardiomyopathy group was 29.03%(18/62),significantly higher than 14.58%(49/336)in the non-sepsis-induced cardiomyopathy group.All differences were statistically significant(all P<0.05).Multivariate Logistic regression analysis showed that the influence of age on sepsis-induced cardiomyopathy was statistically significant(OR=1.010,95%CI 1.003-1.017,P=0.006).The higher the lactic acid level,the higher the risk of sepsis-induced cardiomyopathy,with statistical significance(OR=1.163,95%CI 1.034-1.308,P=0.012).The higher the cTnI level,the higher the risk of sepsis-induced cardiomyopathy,with statistical significance(OR=9.929,95%CI 4.651-21.197,P<0.001).Conclusions Compared with children with non-sepsis-induced cardiomyopathy,children with sepsis-induced cardiomyopathy are more prone to septic shock and have higher mortality.Age,lactic acid and cTnI levels are the independent influencing factors for sepsis-induced cardiomyopathy in children.
郭恩玉;房艳岭;耿化晓;王文杰;李姗姗;孟祥兰;张海防
济宁市第一人民医院儿科,山东 济宁 272000济宁市第一人民医院儿科,山东 济宁 272000||济宁医学院附属医院儿科,山东 济宁 272000
儿童脓毒症脓毒性心肌病危险因素临床特征脓毒性休克
ChildrenSepsisSepsis-induced cardiomyopathyRisk factorsClinical characteristicsSeptic shock
《新医学》 2024 (005)
348-353 / 6
济宁市第一人民医院"启航"科研项目(2021-QHM-001)
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