内科2025，Vol.20Issue(5)：513-517,5.DOI:10.16121/j.cnki.cn45-1347/r.2025.05.09
感染性休克患者继发肝损伤的临床特点及影响因素分析
Clinical characteristics and influencing factors of secondary liver injury in patients with septic shock
摘要
Abstract
Objective To analyze the clinical characteristics and influencing factors of secondary liver injury in patients with septic shock.Methods A cross-sectional study was conducted,and 336 patients with septic shock were selected as the research subjects.According to the presence or absence of secondary liver injury,the patients were divided into either the liver injury group(n=156)or the control group(without liver injury,n=180).General data,infection status,disease severity scores(Acute Physiology and Chronic Health Evaluation Ⅱ[APACHE Ⅱ]score,Sequential Organ Failure Assessment[SOFA]score),laboratory indicators,complications,and prognostic indicators of the two groups were collected.Univariate analysis and multivariate logistic regression analysis were used to screen the independent influencing factors of secondary liver injury in patients with septic shock.Results The incidence of multiple organ dysfunction syndrome,incidence of coagulation disorders,length of stay in the intensive care unit,and 30-day mortality in the liver injury group were all higher/longer than those in the control group(all P<0.05).Univariate analysis results showed that there were statistically significant differences between the two groups in Klebsiella pneumoniae infection,APACHE Ⅱ score,SOFA score,platelet count,fibrinogen(Fib)level,and D-dimer level(all P<0.05).Results of multivariate logistic regression analysis showed that increased SOFA score(OR=1.358,95%CI:1.205-1.530)and increased D-dimer level(OR=1.044,95%CI:1.024-1.065)were independent risk factors for secondary liver injury in patients with septic shock;while high platelet count(OR=0.955,95%CI:0.992-0.998)and high Fib level(OR=0.771,95%CI:0.645-0.922)were independent protective factors(all P<0.05).Conclusion Patients with septic shock complicated by secondary liver injury have a worse clinical prognosis.SOFA score,platelet count,Fib level,and D-dimer level are independent influencing factors for secondary liver injury in patients with septic shock;monitoring these indicators may aid in the early identification of high-risk patients.关键词
感染性休克/肝损伤/临床特点/影响因素/死亡率Key words
Septic shock/Liver injury/Clinical characteristics/Influencing factors/Mortality分类
医药卫生引用本文复制引用
ZHANG Lizhen,ZHOU Ming,HUANG Huaxing,PANG Jihao,TAN Jingjing,WANG Jiamin,ZHANG Wenlin,LUO Yueqin,CHEN Yaozhi..感染性休克患者继发肝损伤的临床特点及影响因素分析[J].内科,2025,20(5):513-517,5.基金项目
北海市科技计划项目(北科合20230213Z) （北科合20230213Z）
