糖尿病、肝硬化及其交互作用对脓毒症患者并发急性肾损伤的影响

doi:10.20047/j.issn1673-7210.2023.23.28

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Abstract Objective To explore the impact of diabetes, cirrhosis, and their interaction on patients with sepsis complicated by acute kidney injury (AKI). Methods Patients with sepsis admitted to the emergency intensive care unit of the Second Affiliated Hospital of Hainan Medical College from January 2016 to December 2021 were included and divided into two groups according to whether they had concurrent AKI. Clinical data, biochemical indicators, sequential organ failure assessment (SOFA) score, and vital signs were compared between the two groups. Binary logistic regression model was used to analyze the independent risk factors of AKI in patients with sepsis. The effects of diabetes, cirrhosis, and their interaction on AKI in patients with sepsis were analyzed by multiplicative model and additive model. Results After adjusting for confounding factors such as gender, age, underlying diseases, laboratory indicators, SOFA score, and vital signs, the results of binary logistic regression analysis model showed: among sepsis patients, the risk of AKI in patients with diabetes was 3.587 times (95%CI: 2.865, 4.491) that of those without diabetes, and the risk of AKI in patients with cirrhosis was 2.766 times (95%CI: 2.407, 3.261) that of those without cirrhosis. After adjusting for hypertension, white blood cell count, C-reaction protein, 1-hour lactic acid value, SOFA score, and other factors, diabetes and cirrhosis had additive and multiplicative interaction on AKI in sepsis patients. Conclusion Diabetes and cirrhosis are independent risk factors for AKI in patients with sepsis, and their multiplicative and additive interactions increase the risk of AKI in patients with sepsis.

Key words： Diabetes Cirrhosis Sepsis Acute kidney injury Interaction

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	TONG Lizhen LIN Mingjiang XING Bo

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TONG Lizhen LIN Mingjiang XING Bo. Influence of diabetes, cirrhosis, and their interaction on acute kidney injury in patients with sepsis[J]. 中国医药导报, 2023, 20(23): 131-134.

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https://www.yiyaodaobao.com.cn/EN/10.20047/j.issn1673-7210.2023.23.28 OR https://www.yiyaodaobao.com.cn/EN/Y2023/V20/I23/131

[1] Evans L，Rhodes A，Alhazzani W，et al. Surviving sepsis campaign：international guidelines for management of sepsis and septic shock 2021 [J]. Crit Care Med，2021，47（11）：1181- 1247.
[2] 朱成楼，陆平，顾艳芬，等.脓毒血症患者不同血糖水平的临床特征及预后分析[J].中国医药科学，2021，11（11）：212-215.
[3] Zador Z，Landry A，Cusimano MD，et al. Multimorbidity states associated with higher mortality rates in organ dysfunction and sepsis：a data-driven analysis in critical care [J]. Critical Care （London，England），2019，23（1）：247.
[4] Philips CA，Sarin SK. Sepsis in cirrhosis：emerging concepts in pathogenesis，diagnosis and management [J]. Hepatol Int，2016，10（6）：871-882.
[5] Gustot T，Durand F，Lebrec D，et al. Severe sepsis in cirrh- osis [J]. Hepatology （Baltimore，Md），2009，50（6）：2022-2033.
[6] Fan C，Ding X，Song Y. A new prediction model for acute kidney injury in patients with sepsis [J]. Ann Palliat Med，2021，10（2）：1772-1778.
[7] Gorecki G，Cochior D，Moldovan C，et al. Molecular mechanisms in septic shock （Review） [J]. Exp Ther Med，2021，22（4）：1161.
[8] Zarbock A，Gomez H，Kellum JA. Sepsis-induced acute kidney injury revisited：pathophysiology，prevention and future therapies [J]. Curr Opin Crit Care，2014，20（6）：588-595.
[9] 曾小娜，尹连红，许丽娜.脓毒症性急性肾损伤发病机制[J].生理科学进展，2020，51（2）：122-126.
[10] Bouglé A，Duranteau J. Pathophysiology of sepsis-induced acute kidney injury：the role of global renal blood flow and renal vascular resistance [J]. Contrib Nephrol，2011，174：89-97.
[11] Liu J，Xie H，Ye Z，et al. Rates，predictors，and mortality of sepsis-associated acute kidney injury：a systematic review and meta-analysis [J]. BMC Nephrol，2020，21（1）：318.
[12] Malhotra R，Kashani KB，Macedo E，et al. A risk prediction score for acute kidney injury in the intensive care unit [J]. Nephrol Dial Transplant，2017，32（5）：814-822.
[13] Zohar Y，Zilberman Itskovich S，Koren S，et al. The asso- ciation of diabetes and hyperglycemia with sepsis outcomes：a population-based cohort analysis [J]. Intern Emerg Med，2021，16（3）：719-728.
[14] Kellum JA，Lameire N. Diagnosis，evaluation，and manage- ment of acute kidney injury：a KDIGO summary （Part 1） [J]. Critical Care （London，England），2013，17（1）：204.
[15] 中华医学会肝病学分会.肝硬化诊治指南[J].现代医药卫生，2020，36（2）：320，I0001-I00018.
[16] 中华医学会糖尿病学分会.中国2型糖尿病防治指南（2020年版）[J].国际内分泌代谢杂志，2021，41（5）：482- 548.
[17] Seymour CW，Liu VX，Iwashyna TJ，et al. Assessment of Clinical Criteria for Sepsis：For the Third International Con- sensus Definitions for Sepsis and Septic Shock （Sepsis-3） [J]. Jama，2016，315（8）：762-774.
[18] Ronco C，Bellomo R，Kellum JA. Acute kidney injury [J]. Lancet （London，England），2019，394（10212）：1949-1964.
[19] 丁松，陈烨，刘慧娇.脓毒血症患者不同血糖水平的临床特征及预后分析[J].中外医疗，2022，41（16）：63-66.
[20] Jiang L，Cheng M. Impact of diabetes mellitus on outcomes of patients with sepsis：an updated systematic review and meta-analysis [J]. Diabetol Metab Syndr，2022，14（1）：39.
[21] Wang Z，Ren J，Wang G，et al. Association Between Diabetes Mellitus and Outcomes of Patients with Sepsis：A Meta- Analysis [J]. Med Sci Monit，2017，23：3546-3555.
[22] 周玉军，何凤芝.肝硬化患者感染性休克临床特征及预后[J].中国实用医药，2021，16（35）：90-92.
[23] Kim TS，Choi DH. Liver Dysfunction in Sepsis [J]. Korean J Gastroenterol，2020，75（4）：182-187.
[24] Tariq R，Hadi Y，Chahal K，et al. Incidence，Mortality and Predictors of Acute Kidney Injury in Patients with Cirrhosis：A Systematic Review and Meta-analysis [J]. J Clin Transl Hepatol，2020，8（2）：135-142.
[25] Chancharoenthana W，Leelahavanichkul A. Acute kidney injury spectrum in patients with chronic liver disease：Where do we stand? [J]. World J Gastroenterol，2019，25（28）：3684- 3703.
[26] Kumar R. Hepatogenous Diabetes：An Underestimated Pro- blem of Liver Cirrhosis [J]. Indian J Endocrinol Metab，2018， 22（4）：552-559.