BACKGROUND The central link between septic shock and acute skin failure(ASF)is the inflammatory response,which occurs throughout disease progression and can lead to systemic inflammatory response syndrome.Patients oft...BACKGROUND The central link between septic shock and acute skin failure(ASF)is the inflammatory response,which occurs throughout disease progression and can lead to systemic inflammatory response syndrome.Patients often experience bad moods,sleep disorders,and other health issues.Despite recognizing these factors,no studies have examined the correlation between inflammatory factors,lactic acid levels,ASF,mood disturbances,and sleep quality in critically ill patients.We hypothesize that higher levels of inflammatory factors and lactic acid are associated with more severe ASF and poorer mood and sleep quality,which may inform clinical treatment for septic shock and ASF.AIM To explore the relationship between inflammatory factors,lactic acid levels,the severity of ASF,bad mood,and sleep quality.METHODS The retrospective study included 150 patients with septic shock from the Second Hospital of Dalian Medical University,categorized into ASF(n=35)or non-ASF groups(n=115).We compared the peripheral blood inflammatory factors,including tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6),lactic acid levels,skin mottling score(SMS),modified early warning score(MEWS),self-rating depression scale(SDS),self-rating anxiety scale(SAS),and Pittsburgh sleep quality index(PSQI)scores.Pearson correlation analysis assessed relationships among these variables.RESULTS The ASF group had significantly higher levels of CRP(19.60±4.10 vs 15.30±2.96 mg/mL),IL-6(298.65±48.65 vs 268.66±33.66 pg/L),procalcitonin,lactic acid(8.42±2.32 vs 5.70±1.27 mmol/L),SMS[0(0,1)vs 3(2,3)],MEWS(9.34±1.92 vs 6.48±1.96),SAS(61.63±12.03 vs 53.71±12.48),SDS(60.17±12.64 vs 52.27±12.64),and PSQI scores(14.23±3.94 vs 8.69±2.46)compared with the non-ASF group(all P<0.001).Pearson correlation analysis revealed that IL-6,CRP,TNF-α,and lactic acid were positively correlated with SMS,MEWS,SAS,SDS,and PSQI scores(P<0.05).CONCLUSION Peripheral blood levels of IL-6,CRP,TNF-α,and lactic acid correlate positively with SMS,MEWS,SAS,SDS,and PSQI in critically ill patients with ASF.展开更多
文摘BACKGROUND The central link between septic shock and acute skin failure(ASF)is the inflammatory response,which occurs throughout disease progression and can lead to systemic inflammatory response syndrome.Patients often experience bad moods,sleep disorders,and other health issues.Despite recognizing these factors,no studies have examined the correlation between inflammatory factors,lactic acid levels,ASF,mood disturbances,and sleep quality in critically ill patients.We hypothesize that higher levels of inflammatory factors and lactic acid are associated with more severe ASF and poorer mood and sleep quality,which may inform clinical treatment for septic shock and ASF.AIM To explore the relationship between inflammatory factors,lactic acid levels,the severity of ASF,bad mood,and sleep quality.METHODS The retrospective study included 150 patients with septic shock from the Second Hospital of Dalian Medical University,categorized into ASF(n=35)or non-ASF groups(n=115).We compared the peripheral blood inflammatory factors,including tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6),lactic acid levels,skin mottling score(SMS),modified early warning score(MEWS),self-rating depression scale(SDS),self-rating anxiety scale(SAS),and Pittsburgh sleep quality index(PSQI)scores.Pearson correlation analysis assessed relationships among these variables.RESULTS The ASF group had significantly higher levels of CRP(19.60±4.10 vs 15.30±2.96 mg/mL),IL-6(298.65±48.65 vs 268.66±33.66 pg/L),procalcitonin,lactic acid(8.42±2.32 vs 5.70±1.27 mmol/L),SMS[0(0,1)vs 3(2,3)],MEWS(9.34±1.92 vs 6.48±1.96),SAS(61.63±12.03 vs 53.71±12.48),SDS(60.17±12.64 vs 52.27±12.64),and PSQI scores(14.23±3.94 vs 8.69±2.46)compared with the non-ASF group(all P<0.001).Pearson correlation analysis revealed that IL-6,CRP,TNF-α,and lactic acid were positively correlated with SMS,MEWS,SAS,SDS,and PSQI scores(P<0.05).CONCLUSION Peripheral blood levels of IL-6,CRP,TNF-α,and lactic acid correlate positively with SMS,MEWS,SAS,SDS,and PSQI in critically ill patients with ASF.
文摘目的 探讨影响感染性休克患者预后的危险因素。方法 回顾性选取2023年1月—2024年1月广州中医药大学茂名医院收治的180例感染性休克患者的临床资料,根据患者出院时预后将其分为存活组(135例)和死亡组(45例)。进行单因素和多因素Logistic回归分析感染性休克患者预后的危险因素。结果 单因素分析:两组的年龄、高血压史、糖尿病史、血乳酸水平、血小板水平、急性生理与慢性健康状况评估(Acute Physiology and Chronic Health Evaluation II, APACHE II)评分、序贯器官衰竭评估(Sequential Organ Failure Assessment,SOFA)评分、6h内最低pH值比较,差异有统计学意义(P均<0.05)。多因素分析:年龄≥60岁(OR=2.438)、合并高血压(OR=2.038)、合并糖尿病(OR=1.958)、高血乳酸水平(OR=3.180)、APACHE II评分(OR=2.059)、SOFA评分(OR=3.473)、6 h内最低pH值(OR=2.300)为影响感染性休克患者预后的危险因素(P均<0.05)。结论 年龄≥60岁、合并高血压、合并糖尿病、高血乳酸水平、APACHE II评分、SOFA评分、6 h内最低pH值为影响感染性休克患者预后的危险因素。