JAHA:法洛四联症患儿术前淋巴细胞**计数的预后价值

2021-05-17 MedSci原创 MedSci原创

法洛四联症(TOF)是最常见的紫绀型先天性心脏病,术前较低的ALC是TOF患儿预后不良的独立预测因素。

法洛四联症(TOF)是最常见的紫绀型先天性心脏病。淋巴细胞绝对计数(ALC)是一种低成本和易于获取的炎症指标;然而,其与TOF患者预后的关系尚未明确。

近日,血管疾病领域权威杂志JAHA上发表了一篇研究文章,该研究旨在探讨TOF患儿术前ALC的预后价值。

该回顾性研究纳入了2016年1月至2018年12月期间在中国阜外医院接受TOF矫形手术的707例年龄在6岁以上的患儿。该研究的终点为死亡、放置体外膜氧合设备、术后住院30天、术后严重并发症;患者根据预后进行分组:预后差(76例)和预后好(631例)。研究人员采用单变量和多变量logistic回归分析确定了预后不良的独立危险因素,并在此基础上建立风险评分系统。研究人员采用受试者工作特性曲线对模型性能进行了评价。研究人员采用另一种不含ALC的模型,评估了添加ALC后的效果。

受试者特征曲线

该研究的结果提示ALC是一个独立的因素,临界值为4.36×109/L。将ALC添加入模型后,曲线下面积从0.771提高到了0.781 (P<0.001)。为避免反向因果关系,研究人员进一步控制了混杂因素,根据ALC水平对患者进行分组,并进行倾向评分匹配。研究人员确定了117对患者进行进一步分析,发现低ALC水平的比值比为3.500 (95%CI为1.413-8.672)。

由此可见,术前较低的ALC是TOF患儿预后不良的独立预测因素

原始出处:

Xie Wu.et al.Prognostic Value of Preoperative Absolute Lymphocyte Count in Children With Tetralogy of Fallot.J AM HEART ASSOC.2021.https://www.ahajournals.org/doi/10.1161/JAHA.120.019098

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    2021-05-19 zhaohui6731
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    2021-05-17 1209e435m98(暂无昵称)

    学习了,谢谢分享

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