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脓毒症继发急性胃肠损伤的危险因素分析
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Abstract:
目的：本研究拟通过二元logistic回归探讨脓毒症患者发生AGI的危险因素。方法：回顾性分析2020年12月至2022年12月新疆医科大学第一附属医院重症医学中心收治的182例脓毒症患者，按是否发生急性胃肠损伤分为AGI组与非AGI组，对患者的一般资料及实验室检查指标进行单因素分析，将获得的有统计学意义的指标采用LASSO回归(套索回归)进行模型变量的初筛，随后将LASSO回归中得到的变量纳入多因素Logistic回归，得出脓毒症患者发生AGI的独立危险因素。结果：研究发现在ICU住院期间采用有创机械通(OR = 7.072, 95%CI: 1.229~40.699, P = 0.028)、LAC增高(OR = 1.806, 95%CI: 1.187~2.746, P = 0.006)、抗生素使用时长(OR = 1.203, 95%CI: 1.015~1.427, P = 0.033)、血管活性药物使用种类(OR = 3.697, 95%CI: 1.667~8.199, P = 0.001)、镇痛及镇静药物使用种类(OR = 2.205, 95%CI: 1.022~4.014, P = 0.043)是脓毒症患者发生急性胃肠损伤的独立危险因素。结论：血乳酸、是否采用有创机械通气治疗、血管活性药物使用种类、抗生素使用时长、镇痛及镇静药物使用种类是脓毒症患者继发AGI的独立危险因素。
Objective: This study aims to explore the risk factors of AGI in patients with sepsis by binary logistic regression. Methods: A total of 182 patients with sepsis admitted to the Intensive Care Unit of the First Affiliated Hospital of Xinjiang Medical University from December 2020 to December 2022 were retrospectively analyzed. According to the presence or absence of acute gastrointestinal injury, the patients were divided into AGI group and non-AGI group. The statistically significant indicators ob-tained were screened by LASSO regression for model variables, and then the variables obtained from LASSO regression were included in multivariate Logistic regression to obtain the independent risk factors for AGI in sepsis patients. Results: The study found that the use of invasive mechanical ventilation during ICU stay (OR = 7.072, 95%CI: 1.229~40.699, P = 0.028), increased LAC (OR = 1.806, 95%CI: 1.187~2.746, P = 0.006), duration of antibiotic use (OR = 1.203, 95%CI: 1.015~1.427, P = 0.033), type of vasoactive agents used (OR = 3.697, 95%CI: 1.667~8.199, P = 0.001), the types of analgesic and sedative drugs used (OR = 2.205, 95%CI: 1.022~4.014, P = 0.043) were independent risk factors for acute gastrointestinal injury in patients with sepsis. Conclusions: Blood lactic acid, invasive mechanical ventilation, vasoactive drugs, duration of antibiotics, analgesic and sedative drugs are independent risk factors for AGI secondary to sepsis.
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