دورية أكاديمية
أعرض في EDS

Amyloid A and lactic acid as a predictor in patients with sepsis in patients with liver cirrhosis.

التفاصيل البيبلوغرافية
العنوان: Amyloid A and lactic acid as a predictor in patients with sepsis in patients with liver cirrhosis.
المؤلفون: Li Q; Emergency Medicine, Fushun People's Hospital, Zigong, Sichuan, China. xiaoqiang0403@163.com., Zeng R; Emergency Medicine, Fushun People's Hospital, Zigong, Sichuan, China., Sun Y; Emergency Medicine, Fushun People's Hospital, Zigong, Sichuan, China., Xu W; Department of Critical Care Medicine, Fushun People's Hospital, Zigong, Sichuan, China., Xie Z; Emergency Medicine, Fushun People's Hospital, Zigong, Sichuan, China., Jing B; Emergency Medicine, Fushun People's Hospital, Zigong, Sichuan, China., Zhang T; Emergency Medicine, Fushun People's Hospital, Zigong, Sichuan, China.
المصدر: BMC gastroenterology [BMC Gastroenterol] 2024 Jul 22; Vol. 24 (1), pp. 227. Date of Electronic Publication: 2024 Jul 22.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100968547 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-230X (Electronic) Linking ISSN: 1471230X NLM ISO Abbreviation: BMC Gastroenterol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Sepsis*/blood , Sepsis*/complications , Liver Cirrhosis*/blood , Liver Cirrhosis*/complications , Serum Amyloid A Protein*/analysis , Serum Amyloid A Protein*/metabolism , Lactic Acid*/blood, Humans ; Male ; Female ; Middle Aged ; Case-Control Studies ; Prognosis ; Risk Factors ; Aged ; ROC Curve ; Biomarkers/blood ; Logistic Models
مستخلص: Background: Sepsis is triggered by pathogenic microorganisms, resulting in a systemic inflammatory response. Liver cirrhosis and sepsis create a vicious cycle: cirrhosis weakens immune function, raising infection risk and hindering pathogen clearance. Optimal treatment outcomes depend on understanding liver cirrhosis patients' sepsis risk factors. Thus, preventing sepsis involves addressing these risk factors. Therefore, early identification and understanding of clinical characteristics in liver cirrhosis patients with sepsis are crucial for selecting appropriate antibiotics. A case-control study using logistic regression was conducted to examine the prognostic value of amyloid A/lactate level monitoring in identifying sepsis risk factors in liver cirrhosis patients.
Methods: From March 2020 to March 2022, 136 liver cirrhosis patients treated at our hospital were divided into a sepsis group (n = 35) and a non-sepsis group (n = 101) based on sepsis complications. General clinical data were collected. Univariate analysis screened for liver cirrhosis patients' sepsis risk factors. Multivariate logistic analysis was subsequently employed to evaluate the risk factors. Sepsis patients were followed up for a month. Based on prognosis, patients were categorized into a poor prognosis group (n = 16) and a good prognosis group (n = 19). Serum amyloid A (SAA) and blood lactic acid (BLA) levels were compared between the two groups. The receiver operating characteristic (ROC) curve was used to evaluate the prognostic value of both individual and combined SAA/BLA monitoring.
Results: Patient data, including age, diabetes history, liver cancer, hepatic artery embolization, recent antibiotic use, invasive procedures within two weeks, APACHE II Scoring, ALB and SAA and BLA levels, were compared between the sepsis and non-sepsis groups, showing significant differences (P < 0.05). Logistic regression identified factors such as age ≥ 70, recent antibiotic use, recent invasive procedures, history of liver cancer, hepatic artery embolization history, high APACHE II scores, decreased albumin, and elevated SAA and BLA levels as independent sepsis risk factors in liver cirrhosis patients (P < 0.05). Among the 35 sepsis patients, 16 had a poor prognosis, representing an incidence rate of 45.71%. Serum SAA and BLA levels were significantly higher in the poor prognosis group than in the good prognosis group (P < 0.05). The AUC for serum SAA and BLA was 0.831 (95%CI: 0.738-0.924), 0.720 (95%CI: 0.600-0.840), and 0.909 (95%CI: 0.847-0.972), respectively. The combined diagnostic AUC was significantly higher than that of single factor predictions (P < 0.05). The predictive value ranked as follows: joint detection > SAA > BLA.
Conclusion: In treating liver cirrhosis, prioritize patients with advanced age, a history of hepatic artery embolization, recent invasive operations, history of liver cancer, recent antibiotic exposure, high APACHE II scores and low albumin. Closely monitoring serum SAA and BLA levels in these patients can offer valuable insights for early clinical prevention and treatment.
(© 2024. The Author(s).)
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معلومات مُعتمدة: Q22088 Sichuan Medical Youth Innovation Research Project; Q22088 Sichuan Medical Youth Innovation Research Project; Q22088 Sichuan Medical Youth Innovation Research Project; Q22088 Sichuan Medical Youth Innovation Research Project; Q22088 Sichuan Medical Youth Innovation Research Project; Q22088 Sichuan Medical Youth Innovation Research Project; Q22088 Sichuan Medical Youth Innovation Research Project; JH23011 Sichuan Provincial Primary Nursing Special Scientific Research Project Plan; JH23011 Sichuan Provincial Primary Nursing Special Scientific Research Project Plan; JH23011 Sichuan Provincial Primary Nursing Special Scientific Research Project Plan; JH23011 Sichuan Provincial Primary Nursing Special Scientific Research Project Plan; JH23011 Sichuan Provincial Primary Nursing Special Scientific Research Project Plan; JH23011 Sichuan Provincial Primary Nursing Special Scientific Research Project Plan; JH23011 Sichuan Provincial Primary Nursing Special Scientific Research Project Plan; 2023YKYXT11 Zigong Key Science and Technology Plan ( Collaborative Innovation Project of Zigong Academy of Medical Sciences) in 2023; 2023YKYXT11 Zigong Key Science and Technology Plan ( Collaborative Innovation Project of Zigong Academy of Medical Sciences) in 2023; 2023YKYXT11 Zigong Key Science and Technology Plan ( Collaborative Innovation Project of Zigong Academy of Medical Sciences) in 2023; 2023YKYXT11 Zigong Key Science and Technology Plan ( Collaborative Innovation Project of Zigong Academy of Medical Sciences) in 2023; 2023YKYXT11 Zigong Key Science and Technology Plan ( Collaborative Innovation Project of Zigong Academy of Medical Sciences) in 2023; 2023YKYXT11 Zigong Key Science and Technology Plan ( Collaborative Innovation Project of Zigong Academy of Medical Sciences) in 2023; 2023YKYXT11 Zigong Key Science and Technology Plan ( Collaborative Innovation Project of Zigong Academy of Medical Sciences) in 2023
فهرسة مساهمة: Keywords: BLA; Liver cirrhosis; SAA; Sepsis
المشرفين على المادة: 0 (Serum Amyloid A Protein)
33X04XA5AT (Lactic Acid)
0 (Biomarkers)
تواريخ الأحداث: Date Created: 20240722 Date Completed: 20240722 Latest Revision: 20240822
رمز التحديث: 20240822
مُعرف محوري في PubMed: PMC11265147
DOI: 10.1186/s12876-024-03326-4
PMID: 39039452
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-230X
DOI:10.1186/s12876-024-03326-4