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探索疾病轴作为独特集群的替代品,以表征败血症异质性异质性
Zhongheng Zhang1, Lin Chen2, Xiaoli Liu3
1Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China. zh_zhang1984@zju.edu.cn.
Intensive care medicine
|October 4, 2023
概括
整个队列中败血症亚型的可复制性是温和的. 连续的疾病轴,而不是不同的亚型,更好地表征败血症异质性,改善患者分层.
科学领域:
- 关键护理医学 关键护理医学
- 计算生物学 计算生物学
- 生物统计学 生物统计学
背景情况:
- 败血症患者分层是有效治疗的关键.
- 之前的研究已经确定了败血症亚型,但它们的可复制性是不确定的.
- 了解败血症异质性是改善患者治疗结果的关键.
研究的目的:
- 在多个独立的患者队伍中评估败血症亚型的可重复性.
- 为了比较不同的聚类方法来识别败血症亚型.
- 用主要成分分析 (PCA) 评估疾病特征的一致性.
主要方法:
- 分析了来自六个队伍的63547名败血症患者.
- 应用27个集群方案,以正常化相互信息 (NMI) 来进行可重复性评估.
- 利用主要成分分析 (PCA) 识别和评估跨队列的疾病轴.
主要成果:
- 观察到败血症集群亚型的适度复制性 (中位数NMI:0.080.54).
- 从上向下转移学习的可复制性高 (NMI 中位数:0.64) 比自下而上的方法 (NMI 中位数:0.23).
- PCA揭示了一致的相关性模式,确定了"冲击"和"全身炎症反应综合征 (SIRS) "轴.
结论:
- 败血症亚型跨队列的集群显示出有限的可重复性.
- 连续的疾病轴,反映了共存的生理状态,提供了比离散亚型更强大的毒症异质性的特征.
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