早期肝素治疗可降低高体温脓毒症患者的死亡风险:MIMIC-Ⅳ数据库的回顾性分析  

Early heparin therapy reduces mortality risk in hyperthermic sepsis patients:A retrospective analysis of the MIMIC-Ⅳ database

作　　者：徐浩然 李一鸣[1] 彭志勇[1] Xu Haoran;Li Yiming;Peng Zhiyong(Department of Critical Care Medicine,Zhongnan Hospital of Wuhan University,National Clinical Key Specialty in Critical Care Medicine,Clinical Research Center of Hubei Critical Care Medicine,Wuhan 430071,Hubei,China)

机构地区：[1]武汉大学中南医院重症医学科,重症医学国家临床重点专科,湖北省重症医学临床医学研究中心,湖北武汉430071

出　　处：《生物医学转化》2024年第4期37-44,共8页Biomedical Transformation

基　　金：武汉大学中南医院平台支撑项目(PTXM2023021);国家自然科学基金项目(81971816,81772046,82102273)。

摘　　要：目的 探讨脓毒症患者的体温与凝血功能之间的关联,并分析早期肝素治疗对不同体温脓毒症患者预后的影响。方法 从MIMIC-Ⅳ数据库中利用结构化查询语言(SQL)提取有关数据,通过R(4.3.2)分析患者的临床特征,并探讨不同体温的凝血功能差异以及早期肝素治疗对预后的影响。结果 (1)脓毒症患者体温和死亡率成非线性关系;(2)低体温组(≤37.0℃)凝血酶原时间(PT)、部分凝血活酶时间(PTT)更长;(3)早期肝素治疗增加低体温组(≤37.0℃)死亡风险,降低高体温组(> 38.5℃)死亡风险。结论 脓毒症患者的体温与凝血功能存在相关性,适当的体温(37.0~38.5℃)、更短的PT、PTT可能与更好的预后相关,并且早期肝素治疗可以降低高体温(>38.5℃)患者的死亡风险。Objective To investigate the association between body temperature and coagulation function in septic patients,and to evaluate the effect of early heparin therapy on the prognosis of septic patients across varying temperature states.Methods Data were extracted using structured query language(SQL) from the MIMIC-Ⅳdatabase,and clinical characteristics of patients were analyzed with R(4.3.2).Differences in coagulation function across various temperature states and the effect of early heparin therapy on prognosis were examined.Results(1) A non-linear relationship was identified between body temperature and mortality in septic patients;(2) Patients in the hypothermic cohort(≤ 37.0℃) demonstrated prolonged prothrombin time(PT) and partial thromboplastin time(PTT);(3) Early heparin therapy increased mortality risk in the hypothermic cohort(≤ 37.0℃) but decreased mortality risk in the hyperthermic cohort(> 38.5℃).Conclusion A significant association exists between body temperature and coagulation function in septic patients.An optimal body temperature range(37.0~38.5℃),along with shorter PT and PTT,may be associated with better prognosis.Early heparin therapy can reduce the mortality risk in hyperthermic patients(>38.5℃).

关 键 词：脓毒症 体温 MIMIC数据库 凝血功能 

分 类 号：R631[医药卫生—外科学]