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在血造干细胞移植中急性损伤的预测风险评分
Natacha Rodrigues1, Mariana Fragão-Marques2, Cláudia Costa1
1Division of Nephrology and Renal Transplantation, Centro Hospitalar Universitário Lisboa Norte, EPE, 1649-028 Lisboa, Portugal.
Cancers
|July 29, 2023
概括
这项研究开发了一种新的风险评分,用于预测血造干细胞移植 (HSCT) 后的急性损伤 (AKI). 该得分识别了患有AKI风险较高的患者,改善了移植结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 血液学 血液学 血液学
- 在瘤学瘤学.
背景情况:
- 造血干细胞移植 (HSCT) 是血液恶性瘤的关键治疗方法.
- 急性损伤 (AKI) 是HSCT后的频繁且严重的并发症,与患者的治疗结果较差有关.
- 在移植前预测AKI风险对于主动管理和改善患者护理至关重要.
研究的目的:
- 在接受HSCT的患者中开发和验证AKI的预测风险评分.
- 确定移植时可用的关键变量,这些变量与AKI发展独立相关.
- 提供一个工具,用于早期风险分层的HSCT患者易受AKI.
主要方法:
- 对422名接受HSCT的患者进行了回顾性队列研究.
- 根据KDIGO标准 (肌素和尿液输出) 的AKI定义.
- 多变量分析使用后向渐进回归和与竞争事件的生存分析;使用危险比率开发的风险评分.
主要成果:
- 在研究队列中,AKI的累积发病率为59.1%.
- AKI的主要预测因素包括:造血细胞移植并发症指数≥2,先前存在的慢性病,淋巴瘤或白血病的诊断,以及血小板与淋巴细胞的比率> 171.9.9.
- 开发的风险评分显示了HSCT患者AKI的预测性表现.
结论:
- 本研究提出了首个经过验证的AKI预测风险评分,特别是在HSCT人群中.
- 血小板与淋巴细胞的比率成为一个新的,独立的预测AKI后HSCT.
- 风险评分可以帮助临床医生识别AKI高风险个体,促进及时干预,并可能改善HSCT结果.
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