Etiological characteristics of influenza-like illness in Jiangsu province from 2012 to 2016

Influenza-like illness(ILI)is an acute respiratory infection caused by various pathogens.However,the epidemiologic characteristics of ILI pathogens in Jiangsu province are unclear.To better understand the ILI etiology,the characteristics of the pathogens from nasopharyngeal swab samples of patients with ILI collected from 2012 to 2016 in 6 hospitals in Jiangsu province were studied.The pathogens,including influenza virus,respiratory syncytial virus(RSV),rhinovirus(HRV),adenovirus(ADV),herpes simplex virus(HSV),human coronavirus(hCoV),Streptococcus pneumoniae and Haemophilus influenzae,were detected by real-time PCR.At least one pathogen was identified in 1334 of the patients(40.23%).Among viruses,HRV,influenza A virus(Flu A),ADV and RSV were the most frequently detected.ADV was the only pathogen that was distributed evenly in different years and regions(P>0.05).The etiological distribution varied in different age groups.Streptococcus pneumoniae was the most common pathogen in co-infections with a co-detection rate of 64.57%(319/494).The spectrum of etiologies could help to estimate disease burden and provide guidance for vaccination.

Predicting influenza-like illness trends based on sentinel surveillance data in China from 2011 to 2019:A modelling and comparative study

Background Influenza is an acute respiratory infectious disease with a significant global disease burden.Additionally,the coronavirus disease 2019 pandemic and its related non-pharmaceutical interventions(NPIs)have introduced uncertainty to the spread of influenza.However,comparative studies on the performance of innovative models and approaches used for influenza prediction are limited.Therefore,this study aimed to predict the trend of influenza-like illness(ILI)in settings with diverse climate characteristics in China based on sentinel surveillance data using three approaches and evaluate and compare their predictive performance.Methods The generalized additive model(GAM),deep learning hybrid model based on Gate Recurrent Unit(GRU),and autoregressive moving average-generalized autoregressive conditional heteroscedasticity(ARMA—GARCH)model were established to predict the trends of ILI 1-,2-,3-,and 4-week-ahead in Beijing,Tianjin,Shanxi,Hubei,Chongqing,Guangdong,Hainan,and the Hong Kong Special Administrative Region in China,based on sentinel surveillance data from 2011 to 2019.Three relevant metrics,namely,Mean Absolute Percentage Error(MAPE),Root Mean Squared Error(RMSE),and R squared,were calculated to evaluate and compare the goodness of fit and robustness of the three models.Results Considering the MAPE,RMSE,and R squared values,the ARMA—GARCH model performed best,while the GRU-based deep learning hybrid model exhibited moderate performance and GAM made predictions with the least accuracy in the eight settings in China.Additionally,the models’predictive performance declined as the weeks ahead increased.Furthermore,blocked cross-validation indicated that all models were robust to changes in data and had low risks of overfitting.Conclusions Our study suggested that the ARMA—GARCH model exhibited the best accuracy in predicting ILI trends in China compared to the GAM and GRU-based deep learning hybrid model.Therefore,in the future,the ARMA—GARCH model may be used to predict ILI trends in public health practice across diverse climatic zones,thereby contributing to influenza control and prevention efforts.

Analysis on the Chinese Medicine Syndromes and Demographic Characteristics of Patients with Influenza-Like Illness in Clinics of China

Objective： To investigate Chinese medicine （CM） patterns and epidemiological characters of patients with influenza-like illness （ILI） syndromes in clinics in China. Methods： A prospective multi-center observational epidemiology survey on the clinical CM patterns of ILI and its prevalence was conducted from September 2009 to April 2010. A unified survey questionnaire was developed for data collection of ILI symptoms and CM pattems. Totally 45 hospitals from 22 provinces, municipality cities and autonomous regions of China participated this study. The collected data were input by EPI-data v3.1 and analyzed by SPSS 18.0, which included descriptive analysis and Chi-square test for group comparison. Results： A total of 5,967 ILI patients were included in the study. The proportion of the 18-34 aged group （56.2%） was the largest; students （41.0%） were more than other occupations. Majority of the patients had the wind-heat invading Lung （Fei） syndrome （76%）, while in Southwest China mainly wind-heat invading Lung syndrome and wind-cold tightening the exterior syndrome occurred. The typical symptoms of ILI were ranked as fatigue （80.9%）, cough （72.2%）, sore throat （67.2%）, muscular soreness （67.1%）, headache （65.4%）, aversion to cold （60.1%）, thirst （55.1%） and nasal obstruction （48.1%）. Conclusions： The ILl patients in clinics were mainly teenagers and young adults. In regard to CM syndrome, wind-heat invading Lung syndrome prevailed in all regions except the Southwest China. The characteristics of CM syndrome of ILl patients may be relevant to age and region distribution.

Epidemiology of influenza viruses from 2009-2013-A sentinel surveillance report from Union territory of Puducherry, India

Objective: To report the i ndings of inl uenza surveillance programme from Union territory of Puducherry and to document the clinical and epidemiological data of inl uenza viruses over a i ve year period from 2009-2013. Methods: Respiratory samples were collected from patients with influenza-like illness from 2009-2013 as part of routine diagnostic and surveillance activity. Detection of pandemic inl uenza A(H1N1) 2009, inl uenza A(H3N2) and inl uenza B was done using Real-time PCR. Results: Of the total 2 247 samples collected from patients with inl uenza-like illness during the study period 287(12.7%) and 92(4.0%) were positive for inl uenza A(H1N1) 2009 and inl uenza A(H3N2) respectively. A subset of 557 of these samples were also tested for inl uenza B and 24(4.3%) were positive. Signii cantly higher positivity rate for both viruses was observed in adults when compared with children. The peak positivity of influenza A(H1N1) 2009 was observed in 2009 followed by 2012, while that of inl uenza A(H3N2) was more uniformly distributed with the exception of 2012. Overall mortality rate due to influenza A(H1N1) 2009 was 7.6% while it was 1% for influenza A(H3N2). Each year influenza-like illness and influenza virus activity coincided with period of high rainfall and low temperature except in the first half of 2012. Conclusions: As the sole referral laboratory in this region, the data provides a comprehensive picture of inl uenza activity. This information will be useful in future planning of the vaccine schedule and inl uenza pandemic preparedness.

Effect of human rhinovirus infection in pediatric patients with influenza-like illness on the 2009 pandemic influenza A（H1N1） virus

Background Some research groups have hypothesized that human rhinoviruses （HRVs） delayed the circulation of the 2009 pandemic influenza A（H1N1） virus （A（H1N1）pdm09） at the beginning of Autumn 2009 in France.This study aimed to evaluate the relationship between HRV and A（H1N1）pdm09 in pediatric patients with influenza-like illness in Beijing,China.Methods A systematic analysis to detect A（H1N1）pdm09 and seasonal influenza A virus （FLU A） was performed on 4 349 clinical samples from pediatric patients with influenza-like illness during the period June 1,2009 to February 28,2010,while a one-step real-time RT-PCR （rRT-PCR） assay was used to detect HRV in 1 146 clinical specimens selected from those 4 349 specimens.Results During the survey period,only one wave of A（H1N1）pdm09 was observed.The percentage of positive cases for A（H1N1）pdm09 increased sharply in September with a peak in November 2009 and then declined in February 2010.Data on the monthly distribution of HRVs indicated that more HRV-positive samples were detected in September （2.2％） and October （3.3％）,revealing that the peak of HRV infection in 2009 was similar to that of other years.Among the 1 146 specimens examined for HRVs,21 （1.8％） were HRV-positive,which was significantly lower than that reported previously in Beijing （15.4％ to 19.2％） （P ＜0.01）.Overall,6 samples were positive for both A（H1N1）pdm09 and HRV,which represented a positive relative frequency of 1.60％ and 2.08％ HRV,considering the A（H1N1）pdm09-positive and-negative specimens,respectively.The odds ratio was 0.87 （95％ CI 0.32; 2.44,P=0.80）.Conclusions HRVs and A （H1N1）pdm09 co-circulated in this Chinese population during September and October 2009,and the HRV epidemic in 2009 did not affect A（H1N1）pdm09 infection rates in Beijing,China as suggested by other studies.However,the presence of A（H1N1）pdm09 might explain the unexpected reduction in the percentage of HRV positive cases during the period studied.

Misconceptions and truths for feeding patients in the intensive care unit: Case studies with practical nursing solutions

The Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient published in May 2009 (joint guidelines between the Society of Critical Care Medicine (SCCM) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) have advanced our clinical practice for the nutritional management of critically ill patients. In the current article, we will review how to implement these guidelines using a case study model. Two mechanically ventilated and tube fed patients are discussed, one with pneumonia and the second with severe acute pancreatitis. We address the questions of the feeding timing, method of administration, and management of its complications for these two patients.

Secondary sclerosing cholangitis in a young COVID-19 patient resulting in death:A case report

BACKGROUND With the emergence of severe acute respiratory syndrome coronavirus 2(SARSCoV-2) in late 2019 in Wuhan, China, liver injury in patients with coronavirus disease 2019(COVID-19) due to SARS-CoV-2 infection has been regularly reported in the literature. There are a growing number of publications describing the occurrence of secondary sclerosing cholangitis(SSC) after SARS-CoV-2 infection in various cases. We present a case of sudden onset SSC in a critically ill patient(SSC-CIP) following COVID-19 infection who was previously healthy.CASE SUMMARY A 33-year old female patient was admitted to our University Hospital due to increasing shortness of breath. A prior rapid antigen test showed a positive result for SARS-CoV-2. The patient had no known preexisting conditions. With rapidly increasing severe hypoxemia she required endotracheal intubation and developed the need for veno-venous extracorporeal membrane oxygenation in a setting of acute respiratory distress syndrome. During the patient’s 154-d stay in the intensive care unit and other hospital wards she underwent hemodialysis and extended polypharmaceutical treatment. With increasing liver enzymes and the development of signs of cholangiopathy on magnetic resonance cholangiopancreatography(MRCP) as well as endoscopic retrograde cholangiopancreatography(ERCP), the clinical setting was suggestive of SSC. At an interdisciplinary meeting, the possibility of orthotopic liver transplantation and additional kidney transplantation was discussed due to the constant need for hemodialysis. Following a deterioration in her general health and impaired respiratory function with a reduced chance of successful surgery and rehabilitation, the plan for transplantation was discarded. The patient passed away due to multiorgan failure.CONCLUSION SSC-CIP seems to be a rare but serious complication in patients with SARS-CoV-2 infection, of which treating physicians should be aware. Imaging with MRCP and/or ERCP seems to be indicated and a valid method for early diagnosis. Further studies on the effects of early and late SSC in(post-) COVID-19 patients needs to be performed.

上海市2014—2019年麻疹疑似病例实验室监测结果及病原谱分析

本文旨在探究上海市麻疹疑似病例的病原谱构成。从2014—2019年的3325份麻疹/风疹阴性咽拭子标本中,挑选1197份标本,利用荧光定量PCR技术检测水痘带状疱疹病毒(VZV)、人细小病毒B19、人类疱疹病毒4型(Epstein Barr virus,EBV)、人单纯疱疹病毒1型(HSV-1)、人疱疹病毒6型(HHV-6)、人疱疹病毒7型(HHV-7)、柯萨奇病毒A16(CA16)、柯萨奇病毒A6型(CA6)、柯萨奇病毒A10型(CA10)、肠道病毒71型(EV71)及其它通用肠道病毒(EV)。结果显示,共检测到9种病毒,总检出率为9.7%,未检出混合感染。EBV检出率最高,为1.8%,其次为人疱疹病毒6型(1.7%)、VZV及人细小病毒B19(各1.3%)。其他EV检出率为0.8%;检出CA6、CA10各7例(0.6%);检出HSV-1共6例(0.5%),CA16有4例(0.3%)。人细小病毒B19、VZV主要在未成年人中检出,EBV、HHV-6、CA16、CA6在成人和未成年人中占比相似。VZV、EBV及HHV-6主要在男性中检出,HSV-1主要在女性中检出。本研究提示,在上海市麻疹疑似病例中,除麻疹病毒、风疹病毒外,还存在EB病毒、HSV-1、细小病毒B19等9种病毒,它们均可能引起类似麻疹症状而被临床诊断为麻疹,临床医师诊断时须注意加以鉴别。

急诊住院患者甲状腺激素和非甲状腺性病态综合征对临床结局的预测能力研究

背景急诊住院患者病情复杂,甲状腺激素(thyroid hormone,TH)是评判急诊患者机体状况的代谢指标,而作为重要的TH指标,三碘甲状腺原氨酸(triiodothyronine,T3)与急诊住院患者病情程度的关系仍不清楚。目的探讨T3与非内分泌科急诊住院患者病情程度及相关指标的相关性。方法回顾性纳入2021年1—6月于南京中医药大学附属中西医结合医院急诊病区行TH检测的患者资料,根据TH水平,将其分为非甲状腺性病态综合征(nonthyroidal illness syndrome,NTIS)组和非NTIS组,分析各组的临床特征及其TH水平;并根据临床诊断对住院患者分为3组,即感染组、非感染组及脏器功能受损组,其中感染组又分为脓毒症组、肺部感染组和局部感染组,评价各组的TH水平及低值情况(任一激素低于参考值),并探讨TH激素水平与急诊住院患者死亡风险的关系。结果共纳入175例患者,男性108例,女性67例,平均年龄(66.12±16.23)岁。NTIS的发生率达62.29,其中低T3发生率最高(56.00%),其次为FT3(46.86%)。NTIS组的病死率高于非NTIS组(28.44%vs 10.61%,P=0.006)。脓毒症组和脏器功能受损组并发NTIS的比率最高,分别达83.33%和78.12%,非感染组仅23.52%。ROC曲线分析表明,单独检测T3对死亡风险的预测能力较强(AUC=0.750,95%CI:0.673~0.828,P<0.001)。结论T3是急诊住院患者病情判断的最敏感指标,其次为FT3,T3对死亡风险具有一定的预测价值,急诊危重患者应注意监测甲状腺功能。

影响热射病患者90 d预后的危险因素分析

目的探讨热射病患者90 d预后的危险因素。方法回顾性分析2018年6月至2022年8月该院重症医学科收治的热射病患者89例,根据90 d死亡情况分为存活组(62例)和死亡组(27例),比较2组患者年龄、入院时体温及心率、降温时间、炎症及器官功能障碍的实验室数据、急性生理和慢性健康状况Ⅱ评分、序贯器官衰竭估计(SOFA)评分、格拉斯哥昏迷评分法评分等。结果89例患者中90 d内死亡27例(30.3%)。降温时间、入院时心率、SOFA评分是影响患者生存的独立危险因素(风险比=6.230、1.738、1.042,95%可信区间:2.561~14.521、1.026~2.114、1.011~1.427,P=0.004、0.002、0.023)。降温时间、入院时心率、SOFA评分联合预测热射病患者90 d病死率的受试者工作特征曲线下面积为0.993(95%可信区间:0.976~1.000,P<0.001),灵敏度为1.000,特异度为0.933。结论降温时间、入院时心率、SOFA评分是影响热射病患者90 d生存的因素,3个指标可联合使用预测患者90 d病死率和不良预后。

流感样病例监测系统数据异常波动与预警分析

目的通过分析流感样病例监测系统监测结果,探讨监测系统中数据异动的修订与预警预报方法。方法依据北京市流感监测方案,重点选择流感样病例监测系统中67家监测哨点医院2007年1月1日～1月14日监测数据,对流感样病例占门诊量百分比(ILI%)结果进行调整。结果2007年前2周监测结果显示:ILI%平均为6.50%(范围5.08%～9.37%),调整后ILI%平均为10.75%(范围9.46%～11.57%),调整ILI%指标敏感性和准确性高于未调整的ILI%。结论流感样病例监测系统监测数据易受政策措施、媒体宣传、规章制度等诸多因素影响,密切关注监测数据出现的异常波动,及时核实分析并进行有效的修订,可有效提高监测系统的预警预报能力。

2012-2015年北京市流感监测分析

目的了解北京市2012-2015年流感流行特征和流感病毒优势株的变化。方法使用＂北京市医疗机构传染病监测预警系统＂中二级以上医院流感样病例和百分比的周数据以及流感病原学监测周数据,分析流感样病例发病趋势和流感病毒构成情况。结果 2012年第27周至2015年第26周,北京市流感样病例（ILI）、流感样病例百分比（ILI%）与流感病毒阳性率变化趋势一致（r=0.801,P〈0.001;r=0.737,P〈0.001）,发病高峰为每年冬春季。不同监测季,流感样病例年龄组构成不同（χ^2=2.143,P〈0.001）,各监测季流感病毒亚型构成不同。共报告流感暴发疫情68起,其中62起（91.18%）由甲型H3N2引起,发生在小学校的疫情最多,为35起（51.47%）。结论 2012-2015年甲型H3N2亚型、甲型H1N1流感、乙型Yamagata系均有流行,且各年度优势毒株不一。ILI、ILI%和流感病毒阳性率三者的高峰基本吻合,证实了北京市流感监测系统在预警预测流感流行趋势和暴发疫情中的实际作用。

病例讨论法在医学遗传学教学中的应用

近年在第三军医大学不同专业的本科大专的医学遗传学教学中进行了病例讨论法赏试。689名学生的问卷调查表明:病例讨论法是最受欢迎的教学方法,该方法用于医学遗传学教学的中,绝大多数学生赞成病例讨论法可激发学生学习兴趣。可教学相长,既可提高教师的综合素质,又可提高学生的记忆能力、分析和解决问题的综合能力,还可开发学生的自学、思考和归纳能力,也锻炼他们的表达能力。

应用多重PCR技术快速检测临床标本中常见呼吸道病毒

[目的]应用多重PCR技术快速检测流感样病例和不明原因肺炎病例呼吸道标本中的常见呼吸道病毒,为急性病毒性呼吸道感染的监测和应急处理提供快速诊断手段。[方法]提取标本中病毒核酸RNA/DNA,反转录合成cDNA,多重PCR扩增目的基因,电泳检测扩增产物。[结果]从30份呼吸道标本中检出甲型流感病毒、乙型流感病毒、副流感病毒3型和呼吸道合胞病毒A型。[结论]本研究初步验证了该多重PCR技术能用于快速检测流感样病例和不明原因肺炎病例呼吸道标本中的常见呼吸道病毒。

护理干预对乳腺癌患者疾病不确定感及社会支持的影响

目的探讨护理干预对改善乳腺癌患者的疾病不确定感和社会支持状况的效果。方法66名乳腺癌患者分为实验组33例,对照组33例。实验组在接受病房护士日常健康教育的基础上给予集体化和个体化的护理干预,对照组仅接受病房护士日常的健康教育,对两组在干预前、后分别进行疾病不确定感和社会支持的测量。结果干预前,实验组和对照组在疾病不确定感和社会支持上的测评结果差异无统计学意义(100.2±10.9/104.5±7.2,t=-1.91,P>0.05;39.7±9.4/40.4±8.8,t=-0.31,P>0.05)。护理干预后,实验组的疾病不确定感下降幅度显著高于对照组(26.5±10.6/20.9±10.7,t=-2.12,P=0.038),实验组的社会支持增加也明显高于对照组(4.1±6.1/-0.73±12.3,t'=2.02,P=0.049);干预前疾病不确定感与社会支持之间存在负相关(r=-0.37,P<0.05)。结论护理干预可降低乳腺癌患者的疾病不确定感并提高其社会支持和利用度。

病案首页信息质量保证

为探讨“军字一号”工程中的病案首页的质量管理 ,本文阐述了病案首页信息质量 ;病案首页信息缺陷原因分析 ;病案首页质量保证方法 ;病案首页质量保证措施 ;为“军字一号”工程案首页的质量管理提供经验。

自杀未遂者出院18个月应对方式与社会支持的病例对照研究

目的探讨自杀未遂者自杀行为发生后18个月时的应对方式与社会支持。方法采用应对方式问卷、社会支持量表对111例自杀未遂者(自杀后18个月)及与其性别、年龄和居住地匹配的111例无自杀行为者进行调查并比较。结果自杀未遂者问题解决、求助、客观支持、主观支持、支持利用度、支持总分明显低于对照组,而退避、自责得分明显高于对照组,差异有统计学意义(t值为3.12～6.24,P均小于0.05)。73例无精神疾病自杀未遂者问题解决、求助、客观支持、主观支持、支持利用度、支持总分明显低于其匹配的对照组,差异有统计学意义(t值为2.48～5.88,P均小于0.05)。有精神疾病自杀未遂组问题解决、求助得分比无精神疾病组明显低,而退避、自责得分明显高于无精神疾病组,差异均有统计学意义(t值为2.22～5.48,P均小于0.05),两组社会支持方面得分差异无统计学意义(P>0.05)。结论出院18个月时的自杀未遂者应对方式和社会支持系统依然不良,具有持续性。自杀干预工作应努力提高自杀未遂者的应对能力和支持感受,以减少他们再自杀的可能性。

南京市2010-2014年流感流行病学特征分析

目的分析南京市2010-2014年流感流行病学特征和流感样病例(ILI)的病原学监测结果,为防控流感科学决策提供依据。方法应用描述流行病学方法,对2010-2014年流感监测资料进行统计分析,对病原检测结果进行分类统计分析。结果 2010-2014年ILI报告342 784例,占总门诊人次的4.14%;<15岁少儿占85.03%;甲、乙型流感交替流行;流感暴发疫情主要发生在学校等人员密集场所。结论预防流感的重点人群为<15岁少儿,流行高峰主要出现在秋冬季,南京市2010-2014流感病毒优势株轮流出现,流感监测方法与手段需要进一步改进与加强。

精神分裂症个体的心理理论及其影响因素

目的:探讨精神分裂症个体的心理理论能力特点及其影响因素。方法:被试150名,其中精神分裂症患者108名,情感障碍患者21名,正常被试21名。应用故事?图片法测量心理理论能力,PANSS量表评定精神症状,并利用中国修订韦氏智力量表简式测量智商。结果:在一级心理理论任务成绩上,症状未缓解且智商低于70的精神分裂症患者的成绩低于正常对照组(D=-56·58,P<0·01),在二级心理理论任务成绩上,症状未缓解智商低于70和症状未缓解智商高于70的精神分裂症患者的成绩明显低于正常对照组(D=-70·51,D=-37·78,P<0·01);情感障碍患者和处于缓解期的精神分裂症患者与正常对照组的心理理论任务成绩没有明显差异;精神分裂症患者的一、二级心理理论任务成绩与其言语智商均呈正相关(r分别为0·32、0·51,P<0·01和P<0·001);其病程对心理理论任务成绩没有明显的影响;阳性亚型精神分裂症组的一、二级心理理论任务成绩显著低于正常对照组(D=-21·55,D=-25·53,P<0·01)。结论:精神分裂症患者存在心理理论能力的损伤,并受到精神症状和言语智商的显著影响,但病程的作用不明显。这种损伤可能只是一种状态,而不是一种特质。

血清学指标联合小儿危重病例评分和Brighton儿童早期预警评分预测脓毒症患儿死亡的巢式病例对照研究

背景脓毒症患儿在发病初期因临床表现缺乏特异性,常延误最佳治疗时机导致其预后不佳,病死率较高。此外,脓毒症患儿的一些临床症状常与其他疾病的症状相似,这无疑又增加了脓毒症的误诊率。早期确诊是改善脓毒症患儿并发症导致死亡的最有效方法,因此,本研究旨在探索一种更精确的评估脓毒症患儿死亡的指标。目的评估血清学指标联合小儿危重病例评分(PCIS)、Brighton儿童早期预警评分(PEWS)预测脓毒症患儿死亡的价值。方法选取2015年12月—2016年12月在河北北方学院附属第一医院确诊的脓毒症患儿205例为研究对象。收集患儿一般资料、血清学指标及PCIS、Brighton PEWS。以入院确诊脓毒症/严重脓毒症为起点,死亡或出院为终点,采用巢式病例对照研究方法,将研究期间发生死亡的患儿定义为试验组。另外,每当队列内出现1例患儿死亡时,在该队列尚未死亡的患儿中按1∶1匹配同步选取性别、年龄(<3岁)、原发感染部位等条件相近或相同的患儿作为对照组。患儿死亡影响因素分析采用多因素Logistic回归分析;采用ROC曲线分析降钙素原(PCT)、清蛋白(Alb)、PCIS、Brighton PEWS预测脓毒症患儿死亡的价值。结果根据巢式病例对照研究设计最终共选出94例脓毒症患儿进行分析,试验组47例,对照组47例,病死率为22.9%。试验组1 h内应用抗菌药率、电解质紊乱发生率、休克发生率、MODS受累器官个数、PCT、Brighton PEWS大于对照组,机械通气时间长于对照组,Alb、PCIS小于对照组(P<0.05)。多因素Logistic回归分析结果显示,1 h内应用抗菌药〔OR=1.795,95%CI(1.723,1.870)〕、休克〔OR=1.673,95%CI(1.299,2.154)〕、MODS受累器官个数〔OR=2.132,95%CI(1.507,3.016)〕、PCT〔OR=1.392,95%CI(1.336,1.450)〕、PCIS〔OR=0.553,95%CI(0.477,0.641)〕、Brighton PEWS〔OR=2.536,95%CI(2.268,2.836)〕是脓毒症患儿死亡的影响因素(P<0.05)。Alb联合PCIS、Brighton PEWS预测脓毒症患儿死亡的AUC分别高于其单独预测脓毒症患儿死亡的AUC(P<0.05)。结论 Alb联合PCIS、Brighton PEWS对脓毒症患儿死亡有较好的预测能力,有望作为临床早期预测脓毒症患儿死亡的辅助指标之一。