[在心肺绕道心血管手术中作为败血症预测剂的前素]
Alma Ivette Carrasco-Castilla1, María Del Carmen Jiménez-González2, Edgar Cruz-García3
1Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Cardiología, Departamento de Patología Clínica. Ciudad de México, México.
Revista medica del Instituto Mexicano del Seguro Social
|November 23, 2023
概括
通过心肺旁路进行心血管手术后的24小时和72小时测量的前素水平可以帮助诊断败血症. 特定的切断点为procalcitonin (3.8和8.4 ng/mL) 表示更高的败血症的可能性.
科学领域:
- 心血管外科手术中的生物标志物
- 败血症的诊断和管理
- 免疫染色学检测 免疫染色学检测
背景情况:
- 心肺旁路可以触发过度的炎症反应,可能导致败血症.
- 在接受心血管手术的患者中,早期和准确的败血症诊断至关重要.
研究的目的:
- 调查使用心肺旁路术进行心血管外科手术后患者的前素水平和败血症诊断之间的关联.
- 为了在不同手术后的时间点确定最佳的普卡尔西托尼切断值来检测败血症.
主要方法:
- 一个涉及142名接受心血管外科手术,心肺旁路手术的患者的案例系列研究.
- 在手术后24小时和72小时测量了血清中prokalcitonin的水平,使用临床定量免疫染色学测定.
- 关联分析包括计算曲线下的面积 (AUC),灵敏度,特异性和最佳切线点的预测值.
主要成果:
- 在142名患者中,有7名患者 (4.9%) 在手术后出现了败血症.
- 在24小时后,甲的水平显示AUC为0.921,最佳切线为3.8 ng/mL (灵敏度为0.857,特异性为0.904).
- 在72小时后,公素水平的AUC为0.868,最佳切断值为8.4 ng/mL (灵敏度0.86,特异性0.97).
结论:
- 术后的24小时和72小时的前素水平与心肺绕道心血管手术后的败血症存在有显著联系.
- 在24小时内3.8 ng/mL和72小时后8.4 ng/mL的确定的切线点可以帮助诊断败血症.
- 在这种患者群体中,素作为早期毒症检测的有价值的生物标志物.
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