Journal: Frontier Forum of Clinical Medicine DOI: 10.32629/ffcr.v4i4.21478
Abstract
脓毒症(Sepsis)是宿主对感染反应失调所导致的危及生命的器官功能障碍,其高发病 率和死亡率给全球公共卫生带来了沉重负担。现有研究表明,脓毒症患者普遍存在免 疫功能紊乱、营养状态受损以及炎症反应失控等情况,其中机体的免疫营养状况是影 响其转归的关键因素之一。改良血红蛋白-白蛋白-淋巴细胞- 血小板评分(modified Hemoglobin-Albumin-Lymphocyte-Platelet score,m- HALP)作为一种简单可及并能够综合反映机体免疫水平与营养储备的复合评估指标, 基于常规检验结果即可得出,具有极大的临床应用潜在价值；近年来越来越多的循证 医学证据指出,该评分与脓毒症病情严重程度、器官功能衰竭风险以及临床预后密切 相关。本综述旨在分析m- HALP评分对脓毒症病情评价与预后预测的研究进展,旨在早期识别脓毒症高风险人群 、精准分层疾病严重程度,为脓毒症的临床诊疗与预后判断提供新的思路和方法。
Keywords
m-HALP评分；脓毒症；预后预测；病情评估
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[28] Liang P,Yu F.Value of CRP,PCT,and NLR in Prediction of Severity and Prognosis of Patients With Bloodstream Infectio ns and Sepsis[J].Frontiers in Surgery,2022,9:857218.
[29] Molano-Franco D,Arevalo-Rodriguez I,Muriel A, et al. Basal procalcitonin, C-reactive protein, interleukin-6, and presepsin for prediction of mortality in critically ill septic patients: a systematic review and meta-analysis[J].Diagnostic and Prognostic Research,2023,7:15.
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[31] 梁旭,李国旗,张红玉,等.血乳酸､IL- 6联合SOFA评分对脓毒症患者28d死亡风险的预测价值[J].暨南大学学报(自然科学与医学 版),2024,45(1):43-50.
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[33] Lee, Sang-Min, et al.“Associations of the Serum Albumin Concentration and Sequential Organ Failure Assessment Score at Discharge with 1-Year Mortality in Sepsis Survivors:A Retrospective Cohort Study.”[J] Shock (Augusta, Ga.),vol.59, no.4, Apr.2023,pp.547–52,https://doi.org/10.1097/SHK.0000000000002083.
[34] 常晨铭,闫鹏程,赵常宏,等.HALP评分及改良HALP评分对ICU脓毒性休克患者28天生 存预测分析[J].临床个性化医学,2024,3(4):2455-2463.
[2] Rudd K E,Johnson S C,Agesa K M,等.Global, regional, and national sepsis incidence and mortality, 1990-2017:analysis for the Global Burden of Disease Study[J].Lancet (London,En gland),2020,395(10219):200-211.
[3] Weng L,Zeng X Y,Yin P,等.Sepsis-related mortality in China:a descriptive analysis[J].Intensive Care Medicine,2018,44(7):1071-1080.
[4] Silva EE, Skon-Hegg C, Badovinac VP,et al.The calm after the storm: implications of sepsis immunoparalysis on host immunity[J].Journal of Immunology,2023,211(5):711-719.
[5] Li JY, Mai HY, Chen K, et al. Mechanism of protein-anabolic resistance leading to decreased skeletal muscle mass in elderly sepsis[J].Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition),2026,12(1):109-116.
[6] Sygitowicz G,Sitkiewicz D.Molecular mechanisms of or gan damage in sepsis: an overview[J].The Brazilian Journal of Infectious Diseases:An Official Publication of the Brazili an Society of Infectious Diseases,2020,24(6):552-560.
[7] Chen, Xiao-Long, et al.“Prognostic Significance of the Combination of Preoperative Hemoglobin, Albumin, Lymphocyte and Platelet in Patients with Gastric Carcinoma: A Retrospective Cohort Study.”[J]Oncotarget, vol.6, no. 38,Dec.2015,pp.41370–82, https://doi.org/10.18632/oncotarget.5629.
[8] Lin L,Huang H, Wu M, Chen F,Li C.The modified HALP score is associated with short-term mortality in critically ill patients with sepsis–A cohort study[J].Journal of Infection and Developing Countries,2025,19(6):924-933.
[9] Mertens C,Reuter D,Agarvas AR,et al.Monocyte iron load correlates with immune suppression and sepsis severity:A longitudinal analysis[J].Journal of Infection,2025,91(6):106660.
[10] Xiao L,Ran X,Li S.Development and validation of a predictive nomogram for sepsis-associated severe anemia[J].Intensive Care Medicine,2025.
[11] Sarıdaş A,Çetinkaya R.The Prognostic Value of the CALLY Index in Sepsis:A Composite Biomarker Reflecting Inflammation, Nutrition, and Immunity[J].Diagnostics,2025,15(8):1026.
[12] Wang ZB,Zhang WZ,Chen LL,et al.Lymphopenia in sepsis:a narrative review[J].Critical Care,2024,28:315.
[13] Lordan, Ronan,et al.“Platelet Activation and Prothrombotic Mediators at the Nexus of Inflammation and Atherosclerosis: Potential Role of Antiplatelet Agents.”[J].Blood Reviews,vol.45, Jan.2021,p.100694, https://doi.org/10.1016/j.blre.2020.100694.
[14] Kocaoglu S,Alatli T.The Efficiency of the HALP Score and the Modified HALP Score in Predicting Mortality in Patients with Acute Heart Failure Presenting to the Emergency Department[J].Journal of the College of Physicians and Surgeons Pakistan,2022,32(6):706-711.
[15] Ozcanli Cay O, Kocaoglu S, Kemer Aycan O,Alatli T. The Role of HALP and Modified-HALP Scores in Predicting Critical Acute Bronchiolitis Patients[J].Innovative Journal of Pediatrics,2025,35(2):e151400.
[16] Saridas A,Vural N,Duyan M,Guven HC,Ertas E,Cander B.Comparison of the ability of newly inflammatory markers to predict complicated appendicitis[J].Open Medicine (Warsaw),2024,19(1):10.1515/med-2024-1002.
[17] Demirpolat MT,Şişik A. Effectiveness of the Modified Hemoglobin, Albumin, Lymphocyte, and Platelet Score in Predicting Weight Loss After Laparoscopic Sleeve Gastrectomy[J].Journal of Laparoendoscopic & Advanced Surgical Techniques,2024,34(1):10.1089/lap.2023.0333.
[18] Balkaş G,Ünsal S, Oktar O, Akdogan MC, Gözüküçük M, Üstün Y. Albumin- Based Inflammatory-Nutritional Indices as Novel Biomarkers for Severity Stratification and Re-Hospitalization Risk in Hyperemesis Gravidarum: A Retrospective Case-Control Study[J].Biomedicines. 2026 Jan 16;14(1):197.doi:10.3390/biomedicines14010197.PMID:41595731;PMCID:PMC1283935 6.
[19] Fındık M,Kıyak R.Comparison of PNI,HALP, and Modified HALP Scores in Predicting 90-Day Mortality in Elderly Patients with Acute Ischemic Stroke[J].Frontiers in Neurology,2026,17:1765523.
[20] Singer M,Deutschman C S,Seymour C W,等.The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis- 3)[J].JAMA,2016,315(8):801-810.
[21] Bauer M,Gerlach H, Vogelmann T,等.Mortality in sepsis and septic shock in Europe, North America and Australia between 2009 and 2019-results from a systematic review and meta-analysis[J].Critical Care (London, England),2020,24(1):239.
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[23] Tang, Lingxuan,et al.“Decoding Sepsis: Unraveling Key Signaling Pathways for Targeted Therapies.”[J]Research (Washington,D.C.),vol.8,2025,p.811, https://doi.org/10.34133/research.0811.
[24] Garduno,Alexis, and Ignacio Martín-Loeches.“Targeting Sepsis: Disease Tolerance,Immune Resilience, and Compartmentalized Immunity.”[J] Biomedicines,vol.12, no. 11, Oct.2024,https://doi.org/10.3390/biomedicines12112420.
[25] Fan,J.-B.,Li,Q.-Y.,Feng,X.-F.,Huang,S.-Y.,Wang, R., Liao,F.-Y.,Liu, D.,Liu,W.-Y.,Sun,J.-H.,Zhang,H.-C.,Zhou,H.-T., Jiang,J.-X.,Wang,Z.,& Zeng, L.(2026).The “cytokine storm” in infection and sepsis: win the battle but lose the war[J].Military Medical Research,12(1),95.https://doi.org/10.1186/s40779-025-00678-0.
[26] Wang, Yang,et al.“Interaction between Endothelial Injury and Immune Response in Septic Shock: From Basic Research to Clinical Applications.”[J]Frontiers in Physiology,vol.16,2025,p.1627008, https://doi.org/10.3389/fphys.2025.1627008.
[27] Girardis, Massimo,et al.“Adjunctive Immunotherapeutic Agents in Patients with Sepsis and Septic Shock: A Multidisciplinary Consensus of 23.”[J]Journal of Anesthesia, Analgesia and Critical Care,vol.4,no.1,Apr.2024,p.28, https://doi.org/10.1186/s44158-024-00165-3.
[28] Liang P,Yu F.Value of CRP,PCT,and NLR in Prediction of Severity and Prognosis of Patients With Bloodstream Infectio ns and Sepsis[J].Frontiers in Surgery,2022,9:857218.
[29] Molano-Franco D,Arevalo-Rodriguez I,Muriel A, et al. Basal procalcitonin, C-reactive protein, interleukin-6, and presepsin for prediction of mortality in critically ill septic patients: a systematic review and meta-analysis[J].Diagnostic and Prognostic Research,2023,7:15.
[30] Zhou X,Liu C,Xu Z,等.Combining host immune response biomarkers and clinical scores for early prediction of sepsis in infection patients[J].Annals of Medicine,2024,56(1):2396569.
[31] 梁旭,李国旗,张红玉,等.血乳酸､IL- 6联合SOFA评分对脓毒症患者28d死亡风险的预测价值[J].暨南大学学报(自然科学与医学 版),2024,45(1):43-50.
[32] Su Y,Li D,Deng S,等.Prognostic value of coagulation and fibrinolysis function indexes and NETs for sepsis patients[J]. American Journal of Translational Research,2023,15(6):4164-4171.
[33] Lee, Sang-Min, et al.“Associations of the Serum Albumin Concentration and Sequential Organ Failure Assessment Score at Discharge with 1-Year Mortality in Sepsis Survivors:A Retrospective Cohort Study.”[J] Shock (Augusta, Ga.),vol.59, no.4, Apr.2023,pp.547–52,https://doi.org/10.1097/SHK.0000000000002083.
[34] 常晨铭,闫鹏程,赵常宏,等.HALP评分及改良HALP评分对ICU脓毒性休克患者28天生 存预测分析[J].临床个性化医学,2024,3(4):2455-2463.
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