通讯作者: 拜合提尼沙·吐尔地

DOI：10.12201/bmr.202609.00002

Classification assessment of dynamic hemoglobin decline in sepsis patients and advances in clinical intervention

• 摘要：【】 血红蛋白进行性下降是脓毒症常见并发症,与病情严重程度及临床转归密切相关。血红蛋白动态下降率的预后评估价值优于单一基线检测值,但临床对其分型鉴别、干预路径仍缺乏统一规范。本文系统梳理近年相关研究进展,从病理基础、临床分型、影响因素、预后价值及分层干预五方面进行归纳评述。现有证据表明,脓毒症血红蛋白下降存在明确时序特征,临床可分为稀释性、失血性、炎症性三类病因,通过 “排除稀释 - 排查出血 - 评估炎症” 三步法可快速鉴别。临床需基于病因分型实施分阶段干预,以限制性输血为基础,强化液体管理、营养支持等可干预因素。本文旨在为脓毒症患者早期风险分层与个体化贫血管理提供临床参考。

  关键词： 脓毒症；血红蛋白动态下降率；病因分型；脓毒症相关性贫血；贫血管理；分层干预; ; ; ; ; 

   

  Abstract: Progressive decline in hemoglobin is a common complication of sepsis and is closely related to disease severity and clinical outcomes. The prognostic value of the dynamic rate of hemoglobin drop is better than that of a single baseline measurement, but there’s still no unified guideline for classifying it or deciding on intervention strategies. This article reviews recent research progress in this area, summarizing findings from five aspects: pathological basis, clinical classification, influencing factors, prognostic value, and stratified interventions. Current evidence shows that hemoglobin decline in sepsis has a clear temporal pattern and can clinically be classified into three causes: dilutional, hemorrhagic, and inflammatory. A three-step approach—‘rule out dilution, check for bleeding, assess inflammation’—can quickly distinguish these types. Clinically, interventions should be staged based on the cause, focusing on restrictive transfusion while also emphasizing fluid management, nutritional support, and other modifiable factors. This article aims to provide clinical guidance for early risk stratification and personalized anemia management in sepsis patients.

  Key words: Sepsis; dynamic decline rate of hemoglobin; etiological classification; sepsis-associated anemia; anemia management; stratified intervention

  提交时间：2026-09-01

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2026-08-20	10.12201/bmr.202609.00002V1	下载

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