新生儿败血症不良预后的危险因素：系统综述与荟萃分析。
完整摘要 · 中文译文
目的：通过系统评价和Meta分析综合既往研究结果，评估与新生儿败血症不良预后相关的危险因素，从而为临床早期风险评估提供更多证据。 方法：根据研究目的、人群和研究设计，制定纳入标准、排除标准和详细检索策略。检索8个数据库，包括PubMed、Embase、Web of Science、Cochrane Library、中国知网（CNKI）、万方数据、维普中文科技期刊数据库和中国生物医学文献数据库（CBM），检索时间自建库至2026年1月21日。具体覆盖时间范围如下：PubMed（1946年至2026年1月21日）、Embase（1947年至2026年1月21日）、Cochrane Library（1992年至2026年1月21日）、Web of Science（1900年至2026年1月21日）、CNKI（1915年至2026年1月21日）、维普中文科技期刊数据库（1989年至2026年1月21日）、CBM（1994年至2026年1月21日）和万方数据（1998年至2026年1月21日）。筛选符合纳入标准的研究。研究筛选和数据提取由两名评价员独立完成。采用纽卡斯尔-渥太华量表评估方法学质量，使用RevMan 5.4进行统计分析。 结果：共纳入26项研究。新生儿败血症不良预后的主要独立危险因素如下：① 白细胞介素-6升高[OR = 1.97，p < 0.001]；② 降钙素原升高[ OR = 1.59，p < 0.001]；③ 血小板减少[OR = 2.47，p = 0.020]；④ C反应蛋白升高[OR = 2.04，p = 0.003]；⑤ 白细胞减少[OR = 2.90，p = 0.001]；⑥ 乳酸升高[OR = 2.18，p = 0.005]；⑦ 革兰阴性菌感染[OR = 5.37，p = 0.002]；以及⑧ 白蛋白降低[OR = 5.77，p = 0.001]。 结论：炎症生物标志物升高、血液学异常、高乳酸血症、低白蛋白血症和革兰阴性菌感染是新生儿脓毒症预后不良的重要指标。早期识别这些因素并及时干预可能改善临床结局。 系统评价注册：https://www.crd.york.ac.uk/PROSPERO/view/CRD420261290404，CRD420261290404。
完整摘要 · 英文原文
OBJECTIVE: To synthesize previous research findings through systematic review and meta-analysis and to evaluate risk factors associated with poor prognosis in neonatal sepsis, thereby providing additional evidence for early clinical risk assessment. METHODS: According to the study objectives, population, and study design, the inclusion criteria, exclusion criteria, and detailed search strategy were established. Eight databases were searched, including PubMed, Embase, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP Chinese Science and Technology Journals Database, and the Chinese Biomedical Literature Database (CBM), from database inception to January 21, 2026. The specific coverage periods were as follows: PubMed (1946 to January 21, 2026), Embase (1947 to January 21, 2026), the Cochrane Library (1992 to January 21, 2026), Web of Science (1900 to January 21, 2026), CNKI (1915 to January 21, 2026), VIP Chinese Science and Technology Journals Database (1989 to January 21, 2026), CBM (1994 to January 21, 2026), and Wanfang Data (1998 to January 21, 2026). Studies meeting the inclusion criteria were selected. Study selection and data extraction were independently performed by two reviewers. Methodological quality was assessed using the Newcastle-Ottawa Scale, and statistical analyses were conducted using RevMan 5.4. RESULTS: A total of 26 studies were included. The main independent risk factors for poor prognosis in neonatal sepsis were as follows: ① elevated interleukin-6 [OR = 1.97, p < 0.001]; ② elevated procalcitonin [OR = 1.59, p < 0.001]; ③ thrombocytopenia [OR = 2.47, p = 0.020]; ④ elevated C-reactive protein [OR = 2.04, p = 0.003]; ⑤ leukopenia [OR = 2.90, p = 0.001]; ⑥ elevated lactate [OR = 2.18, p = 0.005]; ⑦ Gram-negative bacterial infection [OR = 5.37, p = 0.002]; and ⑧ decreased albumin [OR = 5.77, p = 0.001]. CONCLUSION: Elevated inflammatory biomarkers, hematologic abnormalities, hyperlactatemia, hypoalbuminemia, and Gram-negative bacterial infection are important indicators of poor prognosis in neonatal sepsis. Early recognition of these factors and timely intervention may improve clinical outcomes. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261290404, CRD420261290404.