目的:探讨重症监护病房(intensive care unit,ICU)收治的尿源性脓毒症患者临床特征的性别差异,为尿源性脓毒症的诊治提供参考.方法:回顾性分析2021年1月 2023年12月医院重症医学二科收治的尿源性脓毒症患者41例为研究对象,男17例,女24例,对不同性别患者的一般资料、干预措施、实验室检查、微生物学培养及临床结局进行分析.结果:两组患者超广谱β-内酰胺酶阳性大肠埃希菌检出率均较高.两组患者的合并症及入ICU时的序贯器官衰竭评分比较,差异无统计学意义(P＞0.05).与男性尿源性脓毒症患者相比,女性患者白细胞计数、体温较高,血红蛋白水平较低;脏器功能方面,女性患者BNP水平较高,血肌酐水平低于男性;女性患者血乳酸水平高于男性;男性患者间羟胺需求量高于女性,均差异有统计学意义(P＜0.05).结论:在尿源性脓毒症状态下,不同性别ICU患者的临床特征存在一定差异,主要表现在炎症反应、心脏和肾脏器官功能状态、间羟胺等血管活性药物需求等方面.临床医生应关注这种异质性并给予个体化治疗.
Sex differences in the clinical characteristics of patients with urosepsis in ICU
Objective:To investigate sex differences in clinical characteristics of intensive care unit(ICU)pa-tients with urosepsis,and to provide reference for the diagnosis and treatment of urosepsis.Methods:A retrospec-tive cohort study was conducted on forty-one ICU patients with urosepsis from January 2021 to December 2023.The patients were divided into two groups based on the physiological sex,and the general information,interven-tional measures,laboratory tests,microbiological culture,and clinical outcomes of the two groups were com-pared.Results:The proportion of female patients with urosepsis in the ICU was higher than that of males.The detection rate of ultra-broad spectrum β-lactamase positive Escherichia coli was higher in both groups.There were no significant differences between the two groups on the comorbidities and sequential organ failure scores on ICU admission.Compared with male patients with urosepsis,female patients had higher white blood cell count,body temperature,and lower hemoglobin levels(P＜0.05).Female patients also had higher BNP and blood lactate lev-els,and lower blood creatinine levels than male patients(P＜0.05).The use of hydroxylamine was higher in male patients than that in female patients(P＜0.05).Conclusion:In the state of urosepsis,there are some differ-ences in clinical characteristics of patients between different genders in ICU,mainly manifested in the inflammato-ry response,functional status of cardiac and renal organs,and the need for vasoactive drugs such as hydroxyla-mine.Clinicians should be aware of this heterogeneity and provide individualized treatment.
urosepsissex differenceintensive care unitheterogeneityclinical characteristics
万方数据
维普
