从内心炎患者的血中性酸酶活动的增加下降
Amila Kahrovic1, Thomas Poschner1, Anna Schober1
1Department of Cardiac Surgery, Medical University of Vienna, 1090 Vienna, Austria.
International journal of molecular sciences
|July 29, 2023
概括
在感染性内心炎手术后,性酸酶 (AP) 的显著下降表明患者的治疗结果较差. 这一发现表明,AP水平可能是未来心脏手术风险评估的关键因素.
科学领域:
- 心脏病学 心脏病学
- 生物化学 生物化学
- 外科手术的结果
背景情况:
- 传染性内心炎是一种严重的疾病,死亡率高.
- 性酸酶 (AP) 水平在败血症和心脏手术后波动.
- 以前的研究将心脏手术后的大量AP下降与不良结果联系起来.
研究的目的:
- 研究因感染性内心炎而接受手术的患者初始性酸酶 (AP) 降低的预后价值.
- 在这个患者队列中,将AP水平与短期和长期结果相关联.
主要方法:
- 对314名患有左侧感染性内心炎的患者进行了回顾性分析.
- 在多个时间点测量血液AP水平:基线,术后1-7日,14,30日.
- 患者根据相对AP下降≥30%与<30%的基础上分层.
主要成果:
- 较高的初始AP下降与增加替代疗法 (21.8%vs7.4%) 和体外膜氧化 (19.0%vs2.2%) 的需求有关.
- 患有较大AP下降的患者经历了显著更高的30天死亡率 (10.6%vs3.0%) 和长期死亡率.
- 较高的AP下降和不良结果之间的关联在统计学上是显著的 (p < 0.015).
结论:
- 在内心炎手术后,性酸酶的初始大幅下降是不利的短期和长期结果的预测因素.
- 在心脏手术患者的风险分层中,应考虑性酸酶动态.
- 进一步的研究可能会验证AP作为指导治疗和预测感染性内心炎预后的生物标志物.
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