系统性炎症与休克严重程度,30天死亡率和心脏病性休克患者治疗反应的相关性
Angela Dettling1,2, Jessica Weimann1, Jonas Sundermeyer1,2
1Department of Cardiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
概括
高C反应蛋白 (CRP) 水平表明心脏性休克 (CS) 患者30天死亡率增加. 机械循环支持 (MCS) 的使用减轻了这种关联,改善了重症患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 炎症研究 炎症研究
背景情况:
- 心脏性休克 (CS) 携带高死亡率,即使有机械循环支持 (MCS).
- 系统性炎症可能会导致CS严重程度和患者的结果.
- C-反应蛋白 (CRP) 是系统性炎症的标志物.
研究的目的:
- 为了研究C-反应蛋白 (CRP) 度与心脏性休克 (CS) 患者的结果之间的关联.
- 确定CRP水平与冲击严重程度,死亡率和对MCS的反应是否相关.
主要方法:
- 从2009年至2019年对1116名未经选择的CS患者进行CRP测量的分析.
- 利用调整后回归模型来评估CRP与冲击严重程度,30天死亡率和MCS治疗反应的关联.
- 在不同冲击严重程度阶段 (SCAI B-E) 评估的CRP水平.
主要成果:
- 较高的CRP度与30天住院死亡率的增加显著相关 (8%的相对风险增加每50mg/l的CRP增加).
- 在调整了CS严重程度和其他混因素后,这种关联仍然存在.
- 在没有MCS的患者中,升高的CRP预测了更高的死亡率,但在接受MCS治疗的患者中,这种效应减弱 (p-相互作用=0.01).
结论:
- 升高的CRP水平是心脏性休克患者30天死亡率增加的重要预测因素.
- 机械循环支持 (MCS) 似乎可以减轻CS中高CRP度的不良预后影响.
- 在CS中,CRP可以作为一种有价值的生物标志物,用于风险分层,特别是在没有MCS的情况下.
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