JACC:新模型可预测生物瓣膜血栓形成(BPVT)

2015-11-25 fsy 译 MedSci原创

生物瓣膜血栓形成(BPVT)被认为是罕见的;这可能与它常常是无法识别的的事实有关。最近的数据表明BPVT对维生素K拮抗剂有反应,这强调了可靠诊断的需要。本研究旨在确定BPVT的诊断功能,并制定BPVT的一个诊断模型。梅奥诊所病理数据库确定了在1997年至2013年间发生BPVT的案例。BPVT患者通过年龄,性别,以及移植的瓣膜结构损坏的患者位置进行了1:2的匹配。研究人员采用多元线性回归和接受者操

生物瓣膜血栓形成(BPVT)被认为是罕见的;这可能与它常常无法识别的事实有关。最近的数据表明BPVT对维生素K拮抗剂有反应,这强调了可靠诊断的需要。

本研究旨在确定BPVT的诊断功能,并制定BPVT的一个诊断模型。

梅奥诊所病理数据库确定了在1997年至2013年间发生BPVT的案例。BPVT患者通过年龄、性别,以及移植的瓣膜结构损坏的患者位置进行了1:2的匹配。研究人员采用多元线性回归和接受者操作特性制定了BPVT的一个诊断模型。

在连续的397例移植生物瓣膜病例中,有46例发生BPVT(11.6%;主动脉瓣29例,二尖瓣9例,三尖瓣7例,肺1例),平均年龄为63岁,68%为男性。30例(65%)在移植>12个月后发生;平均人工生物瓣膜寿命为24个月(病例组) vs 108个月(对照组)(P<0.001)。BPVT的独立预测因子为平均多普勒超声梯度增长从基线起5年内>50%(比值比[OR]:12.7),阵发性房颤(OR:5.19),亚治疗的国际标准化比值(OR:7.37),尖厚度增加(OR:12.2),和异常尖迁移率(OR:6.94)。所有5个诊断特征预测BPVT有76%的敏感性,特异性93%,阳性预测值85%,阴性预测值89%(P<0.001)。

BPVT并不少见,可能会在手术后好几年才出现。临床和超声心动图特征的结合能够可靠诊断BPVT。

原始出处:

Alexander C. Egbe,Sorin V. Pislaru,Patricia A. Pellikka,et al.Bioprosthetic Valve Thrombosis Versus Structural Failure,JACC,2015.11.24

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authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/UdV6ialcayj7Qv8RQm1mVfNYPKxjiaolxwglAZpCo6CwjTicOroW2Xb0Kxnc65viaxGpkuqHW7WzzbYgRLw3qooDoA/132, createdBy=04c22500137, createdName=紫砂壶, createdTime=Thu Feb 04 04:14:00 CST 2016, time=2016-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325140, encodeId=fcb313251402b, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Fri Nov 27 03:14:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1399082, encodeId=838c1399082f1, content=<a href='/topic/show?id=49dd69399c2' target=_blank style='color:#2F92EE;'>#生物瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69399, encryptionId=49dd69399c2, topicName=生物瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/SicjCIAeTxGf3PibxsFPgEb3xtbibdR8KpjNN5V3XkiatR1BXv2o9YPVhSnazedCHtUUh9KJyUmqYnmS3fRlyJZ4Dw/132, createdBy=5c342186905, createdName=liao1620, createdTime=Fri Nov 27 03:14:00 CST 2015, time=2015-11-27, status=1, ipAttribution=)]
    2017-06-03 cuiyejia

    学习了,谢谢

    0

  2. 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    2016-11-26 清幽蓝燕yan

    谢谢小编

    0

  3. 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style='color:#2F92EE;'>#生物瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69399, encryptionId=49dd69399c2, topicName=生物瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/SicjCIAeTxGf3PibxsFPgEb3xtbibdR8KpjNN5V3XkiatR1BXv2o9YPVhSnazedCHtUUh9KJyUmqYnmS3fRlyJZ4Dw/132, createdBy=5c342186905, createdName=liao1620, createdTime=Fri Nov 27 03:14:00 CST 2015, time=2015-11-27, status=1, ipAttribution=)]
    2016-11-24 1771ae4158m

    学习下,不错

    0

  4. 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encodeId=28e916355421e, content=<a href='/topic/show?id=83a3693965d' target=_blank style='color:#2F92EE;'>#生物瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69396, encryptionId=83a3693965d, topicName=生物瓣)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ddce22497218, createdName=396094184_42047362, createdTime=Fri Mar 18 01:14:00 CST 2016, time=2016-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1690714, encodeId=8b491690e147f, content=<a href='/topic/show?id=aefa3649d2' target=_blank style='color:#2F92EE;'>#BPV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3649, encryptionId=aefa3649d2, topicName=BPV)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f31a29086824, createdName=bioon11, createdTime=Sun 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authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/UdV6ialcayj7Qv8RQm1mVfNYPKxjiaolxwglAZpCo6CwjTicOroW2Xb0Kxnc65viaxGpkuqHW7WzzbYgRLw3qooDoA/132, createdBy=04c22500137, createdName=紫砂壶, createdTime=Thu Feb 04 04:14:00 CST 2016, time=2016-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325140, encodeId=fcb313251402b, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Fri Nov 27 03:14:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1399082, encodeId=838c1399082f1, content=<a href='/topic/show?id=49dd69399c2' target=_blank style='color:#2F92EE;'>#生物瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69399, encryptionId=49dd69399c2, topicName=生物瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/SicjCIAeTxGf3PibxsFPgEb3xtbibdR8KpjNN5V3XkiatR1BXv2o9YPVhSnazedCHtUUh9KJyUmqYnmS3fRlyJZ4Dw/132, createdBy=5c342186905, createdName=liao1620, createdTime=Fri Nov 27 03:14:00 CST 2015, time=2015-11-27, status=1, ipAttribution=)]
    2016-09-26 1e0a2178m68(暂无匿称)

    有趣的是预测模型,希望在中国病人中实际应用

    0

  5. 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  6. 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style='color:#2F92EE;'>#生物瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69399, encryptionId=49dd69399c2, topicName=生物瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/SicjCIAeTxGf3PibxsFPgEb3xtbibdR8KpjNN5V3XkiatR1BXv2o9YPVhSnazedCHtUUh9KJyUmqYnmS3fRlyJZ4Dw/132, createdBy=5c342186905, createdName=liao1620, createdTime=Fri Nov 27 03:14:00 CST 2015, time=2015-11-27, status=1, ipAttribution=)]
    2016-07-31 bioon11
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authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/UdV6ialcayj7Qv8RQm1mVfNYPKxjiaolxwglAZpCo6CwjTicOroW2Xb0Kxnc65viaxGpkuqHW7WzzbYgRLw3qooDoA/132, createdBy=04c22500137, createdName=紫砂壶, createdTime=Thu Feb 04 04:14:00 CST 2016, time=2016-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325140, encodeId=fcb313251402b, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Fri Nov 27 03:14:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1399082, encodeId=838c1399082f1, content=<a href='/topic/show?id=49dd69399c2' target=_blank style='color:#2F92EE;'>#生物瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69399, encryptionId=49dd69399c2, topicName=生物瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/SicjCIAeTxGf3PibxsFPgEb3xtbibdR8KpjNN5V3XkiatR1BXv2o9YPVhSnazedCHtUUh9KJyUmqYnmS3fRlyJZ4Dw/132, createdBy=5c342186905, createdName=liao1620, createdTime=Fri Nov 27 03:14:00 CST 2015, time=2015-11-27, status=1, ipAttribution=)]
    2016-04-08 hbwxf
  8. 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GetPortalCommentsPageByObjectIdResponse(id=157798, encodeId=720915e79813, content=学习下,不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/ac01daf0962458a9eb8c0b1e2f6ce5bc.jpg, createdBy=04b81710322, createdName=1771ae4158m, createdTime=Thu Nov 24 07:54:00 CST 2016, time=2016-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=135593, encodeId=3b181355938f, content=有趣的是预测模型,希望在中国病人中实际应用, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cd381919282, createdName=1e0a2178m68(暂无匿称), createdTime=Mon Sep 26 21:14:26 CST 2016, time=2016-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1635542, encodeId=28e916355421e, content=<a href='/topic/show?id=83a3693965d' target=_blank style='color:#2F92EE;'>#生物瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69396, encryptionId=83a3693965d, topicName=生物瓣)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ddce22497218, createdName=396094184_42047362, createdTime=Fri Mar 18 01:14:00 CST 2016, time=2016-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1690714, encodeId=8b491690e147f, content=<a href='/topic/show?id=aefa3649d2' target=_blank style='color:#2F92EE;'>#BPV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3649, encryptionId=aefa3649d2, topicName=BPV)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f31a29086824, createdName=bioon11, createdTime=Sun Jul 31 12:14:00 CST 2016, time=2016-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1853444, encodeId=0dd118534442a, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Fri Apr 08 20:14:00 CST 2016, time=2016-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2054772, encodeId=29652054e7249, content=<a href='/topic/show?id=c81a14914be' target=_blank style='color:#2F92EE;'>#PVT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14914, encryptionId=c81a14914be, topicName=PVT)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/UdV6ialcayj7Qv8RQm1mVfNYPKxjiaolxwglAZpCo6CwjTicOroW2Xb0Kxnc65viaxGpkuqHW7WzzbYgRLw3qooDoA/132, createdBy=04c22500137, createdName=紫砂壶, createdTime=Thu Feb 04 04:14:00 CST 2016, time=2016-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325140, encodeId=fcb313251402b, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Fri Nov 27 03:14:00 CST 2015, time=2015-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1399082, encodeId=838c1399082f1, content=<a href='/topic/show?id=49dd69399c2' target=_blank style='color:#2F92EE;'>#生物瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69399, encryptionId=49dd69399c2, topicName=生物瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/SicjCIAeTxGf3PibxsFPgEb3xtbibdR8KpjNN5V3XkiatR1BXv2o9YPVhSnazedCHtUUh9KJyUmqYnmS3fRlyJZ4Dw/132, createdBy=5c342186905, createdName=liao1620, createdTime=Fri Nov 27 03:14:00 CST 2015, time=2015-11-27, status=1, ipAttribution=)]
    2016-02-04 紫砂壶
  9. 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encodeId=28e916355421e, content=<a href='/topic/show?id=83a3693965d' target=_blank style='color:#2F92EE;'>#生物瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69396, encryptionId=83a3693965d, topicName=生物瓣)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ddce22497218, createdName=396094184_42047362, createdTime=Fri Mar 18 01:14:00 CST 2016, time=2016-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1690714, encodeId=8b491690e147f, content=<a href='/topic/show?id=aefa3649d2' target=_blank style='color:#2F92EE;'>#BPV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3649, encryptionId=aefa3649d2, topicName=BPV)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f31a29086824, createdName=bioon11, createdTime=Sun Jul 31 12:14:00 CST 2016, time=2016-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1853444, encodeId=0dd118534442a, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Fri Apr 08 20:14:00 CST 2016, time=2016-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2054772, encodeId=29652054e7249, content=<a href='/topic/show?id=c81a14914be' target=_blank style='color:#2F92EE;'>#PVT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14914, encryptionId=c81a14914be, topicName=PVT)], attachment=null, 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style='color:#2F92EE;'>#生物瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69399, encryptionId=49dd69399c2, topicName=生物瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/SicjCIAeTxGf3PibxsFPgEb3xtbibdR8KpjNN5V3XkiatR1BXv2o9YPVhSnazedCHtUUh9KJyUmqYnmS3fRlyJZ4Dw/132, createdBy=5c342186905, createdName=liao1620, createdTime=Fri Nov 27 03:14:00 CST 2015, time=2015-11-27, status=1, ipAttribution=)]
  10. [GetPortalCommentsPageByObjectIdResponse(id=206116, encodeId=7d5120611631, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28761705280, createdName=cuiyejia, createdTime=Sat Jun 03 21:41:42 CST 2017, time=2017-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=158313, encodeId=e41c15831374, content=谢谢小编, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJHmctib8wsjB1Y0etxU20nsCbR8rZ2fpibp2STmwH2YzicIsTe9oHRGB6XIMeBqNdIvxODicmzfeQibIw/132, createdBy=82211964557, createdName=清幽蓝燕yan, createdTime=Sat Nov 26 16:44:57 CST 2016, time=2016-11-26, status=1, ipAttribution=), 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style='color:#2F92EE;'>#生物瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69399, encryptionId=49dd69399c2, topicName=生物瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/SicjCIAeTxGf3PibxsFPgEb3xtbibdR8KpjNN5V3XkiatR1BXv2o9YPVhSnazedCHtUUh9KJyUmqYnmS3fRlyJZ4Dw/132, createdBy=5c342186905, createdName=liao1620, createdTime=Fri Nov 27 03:14:00 CST 2015, time=2015-11-27, status=1, ipAttribution=)]