IFABP水平预测在开放胸腔腹腔大动脉修复后的头几个小时内内脏输血
Panagiotis Doukas1, Cathryn Bassett1, Hanif Krabbe1
1Department of Vascular and Endovascular Surgery, University Hospital Aachen, RWTH Aachen University, Aachen, Germany.
Frontiers in cardiovascular medicine
|July 13, 2023
概括
肠道脂肪酸结合蛋白 (IFABP) 在大动脉修复后准确地检测出内脏输血. 在手术后的头12小时内早期测量IFABP,有助于对这种关键并发症及时进行诊断和干预.
科学领域:
- 心血管外科心血管外科
- 胃肠病学 胃肠病学
- 生物标志物发现发现
背景情况:
- 开放胸腔腹腔大动脉修复 (TAAR) 携带肠道缺血的风险,这是一种严重并发症,死亡率高.
- 在TAAR后诊断内脏阻 perfusion 是具有挑战性的,需要迅速的手术干预.
- 肠脂肪酸结合蛋白 (IFABP) 是肠壁损伤的潜在生物标志物.
研究的目的:
- 评估血清IFABP水平在开放TAAR后检测内脏阻 perfusion 的诊断能力.
- 评估IFABP水平与内脏阻 perfusion 的发生之间的相关性.
主要方法:
- 一项前性观察性研究,包括23名接受开放TAAR的患者.
- 在基线和术后 (0,12,24,48小时) 测量血清IFABP,白细胞,CRP,PCT和乳酸.
- 通过CT血管造影证实了内脏输血的诊断;使用ROC分析评估IFABP的预测能力.
主要成果:
- 内膜阻 perfusion 与死亡率的增加有显著相关性 (p=.001).
- 在术后和12小时内,在内脏输血患者中观察到IFABP水平升高.
- 高IFABP度显示了在手术后12小时内检测完 perfusion 的高精度 (AUC 1,灵敏度100%,特异性100%,p<.001).
结论:
- 在术后早期的血清IFABP测量对于在开放TAAR后检测内脏阻 perfusion 是有价值的.
- IFABP作为一个可靠和及时的生物标志物,使得迅速诊断和管理这种并发症.
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