Anesthesiology:Presepsin(sCD14-ST)----心脏手术患者风险分级的新标志

2017-03-29 MedSci MedSci原创

麻醉疼痛科: Presepsin(sCD14-ST):心脏手术患者风险分级的新标志Presepsin(可溶性 CD14 亚型,sCD14-ST)是全身炎症反应综合征和败血症的风险分级的体液标记物。 为了研究presepsin能否作为选择性心脏手术患者风险分级的新标记物,作者以八百五十六名心脏手术患者为研究对象,将其术前血浆中这些标记物(preepsin,降钙素原,N-末端促尿钠肽,半胱氨酸蛋白酶抑

Presepsin(可溶性 CD14 亚型,sCD14-ST)是全身炎症反应综合征和败血症的风险分级的体液标记物。 为了研究presepsin能否作为选择性心脏手术患者风险分级的新标记物,作者以八百五十六名心脏手术患者为研究对象,将其术前血浆中这些标记物(preepsin,降钙素原,N-末端促尿钠肽,半胱氨酸蛋白酶抑制剂C)的浓度和欧洲心脏手术风险评估系统2分别用于患者术后30天(主要结局),6个月和2年的患者存活预测,并将两者的结果进行比较。

最后的结果显示,在这群患者中,三十日的死亡率为3.2%,6个月的死亡率为6.1%,2年的死亡率为10.4%。对比应用生物标记物和风险评估系统预测患者术后死亡风险的结果后,研究人员发现,术后30天死亡患者的术前血浆preepsin中位浓度显著高于存活者:842 pg / ml(306至1246)vs 160 pg / ml(122至234); 差异值167 pg / ml(92-301; P <0.001)。 同样地,术后6个月和2年非存活者的术前血浆preepsin的浓度也显着高于存活者。 

与欧洲心脏手术风险评估系统2相比,患者血浆preepsin浓度能更好地预测术后各个时期,包括30天(C统计量0.88 vs. 0.74),6个月(0.87 vs. 0.76)和 2年(0.81 vs. 0.74)的死亡风险。 Presepsin还是个比半胱氨酸蛋白酶抑制剂C,N-末端促激素利钠肽或降钙素原更好的预后标记物。在进行完统计所需的调整之后,心脏手术患者的术前血浆Presepsin浓度仍然是一个独立的可用于预测心脏手术后死亡风险的指标。

原始出处

Hagen B, Matthias K,Stefan W, Eberhard S,Thomas V, et al. Presepsin (sCD14-ST) Is a Novel Marker for Risk Stratification in Cardiac Surgery Patients. Anesthesiology 4 2017, Vol.126, 631-642.

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    2017-05-11 lq1767
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    2017-09-17 一叶知秋
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    2017-03-31 skhzy
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    2017-03-30 ylzr123

    不错的方式,努力学习,刻苦专研,不断总结出来新经验。

    0

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