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血清白蛋白与肌素比率升高作为心脏移植后结果的保护因素
Qiang Shen1, Dingyi Yao1, Yang Zhao1,2
1Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Frontiers in cardiovascular medicine
|September 25, 2023
概括
血清白蛋白与肌素比率 (ACR) 是心脏移植接受者的有利预后指标. 较高的ACR水平与改善整体存活率和减少术后并发症相关,有助于风险预测.
科学领域:
- 心脏病学 心脏病学
- 移植医学 移植医学
- 生物标志物研究 生物标志物研究
背景情况:
- 最终阶段的心力衰竭需要心脏移植.
- 预后指标对于管理移植结果至关重要.
- 血清白蛋白对心脏移植患者肌素比率 (ACR) 的作用需要进一步研究.
研究的目的:
- 在接受心脏移植的患者中调查血清白蛋白与肌素比率 (ACR) 的预后意义.
- 确定ACR是否可以预测整体生存率和术后并发症.
主要方法:
- 460名心脏移植接受者的回顾性分析 (2015年1月 - 2020年12月).
- 使用Youden指数识别最佳ACR截止值.
- 卡普兰-梅尔生存分析和考克斯对整体生存的比例危险模型.
- 术后并发症的后勤回归.
- 符合性指数 (C指数) 和校准图为风险预测准确性.
主要成果:
- 确定了 37.54 的最佳 ACR 截止值.
- 多变量分析证实了手术前的ACR作为整体存活时间的独立预测指标 (HR:0.504,P <0.001).
- ACR提高了预测1年和5年存活率的诺米图的准确性 (C指数从0.631增加到0.671).
- 手术前的ACR独立预测了呼吸道和并发症,肝损伤,感染和住院死亡率的风险降低.
结论:
- 血清白蛋白与肌素比率 (ACR) 是心脏移植接受者的有利预后指标.
- 可以利用ACR预测整体存活率和术后并发症,提高风险分层.
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