新生儿感染性休克预后预测因素研究进展
Advances in Prognostic Predictors of Neonatal Septic Shock
DOI: 10.12677/acm.2026.163971, PDF,   
作者: 宋达楠, 王建辉*：重庆医科大学附属儿童医院新生儿诊治中心，国家儿童健康与疾病临床医学研究中心，儿童发育疾病研究教育部重点实验室，儿科学重庆市重点实验室，重庆
关键词: 新生儿；感染性休克；预后；预测因素；血管活性–正性肌力评分；Neonatal； Septic Shock； Prognosis； Predictors； Vasoactive-Inotropic Score
摘要: 新生儿感染性休克是败血症的危重阶段，病死率高，早期识别预后不良风险对于指导治疗至关重要。本文旨在综述新生儿感染性休克的临床特征、当前治疗现状，并重点探讨其预后预测指标的研究进展。通过梳理现有文献发现，除低胎龄、低出生体重等传统高危因素外，乳酸及其动态变化(如清除率)是重要的预后生化标志物。近年来，血管活性–正性肌力评分(VIS)这一整合治疗强度的指标在儿童感染性休克中显示出优越的预测价值，但在新生儿群体的证据仍有限。本综述总结现有证据，提出未来应致力于构建整合临床特征、实验室指标及治疗相关指标(如VIS)的新生儿特异性预后预测模型，以改善临床决策。
Abstract: Neonatal septic shock is a critical stage of sepsis with a high mortality rate. Early identification of the risk of poor prognosis is crucial for guiding treatment. This article aims to review the clinical features and current treatment status of neonatal septic shock, with a focus on recent advances in prognostic predictors. A review of the existing literature reveals that, in addition to traditional high-risk factors such as low gestational age and low birth weight, lactate and its dynamic changes (e.g., clearance rate) serve as important biochemical prognostic markers. In recent years, the Vasoactive-Inotropic Score (VIS), an indicator integrating therapeutic intensity, has demonstrated superior predictive value in pediatric septic shock, though evidence in the neonatal population remains limited. This review summarizes the current evidence and suggests that future efforts should focus on developing neonatal-specific prognostic models that integrate clinical characteristics, laboratory indicators, and therapeutic indicators (such as VIS) to improve clinical decision-making.
文章引用：宋达楠, 王建辉. 新生儿感染性休克预后预测因素研究进展[J]. 临床医学进展, 2026, 16(3): 1854-1860. https://doi.org/10.12677/acm.2026.163971

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