低的HDL-C可以作为预测败血症患者持续严重AKI的生物标志物? 一个回顾性队列研究
Wei Jiang1,2, Lin Song1,2, Weilei Gong3
1Medical College, Yangzhou University, Yangzhou, 225001, China.
European journal of medical research
|December 5, 2023
概括
低高密度脂蛋白胆固醇 (HDL-C) 与败血症相关的急性损伤 (SA-AKI) 有关. 然而,早期的血HDL-C水平并不能可靠地预测ICU患者持续的SA-AKI.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 关键护理医学 关键护理医学
- 心血管研究研究心血管研究
背景情况:
- 低高密度脂蛋白胆固醇 (HDL-C) 与败血症相关的急性损伤 (SA-AKI) 的风险增加以及估计膜过率 (eGFR) 的恶化有关.
- HDL-C 具有抗炎,抗氧化和内皮修复特性,Apo A-I模仿性在败血症诱导的功能障碍的动物模型中显示出有前途.
- 早期HDL-C水平对持续的SA-AKI的预测价值仍然不确定.
研究的目的:
- 为了研究血HDL-C水平的诊断价值,在ICU入院后24小时内测量,以预测持续的严重SA-AKI.
- 评估HDL-C是否改善了持续性SA-AKI现有临床模型的预测性能.
主要方法:
- 使用MIMIC IV数据库 (v2.2) 的回顾性队列研究 (v2.2).
- 包括2008年至2019年期间入院于ICU的成人败血病患者,早期血HDL-C测量.
- 主要终点:持续严重的SA-AKI;次要终点:脏替代疗法 (KRT). 使用了后勤回归和ROC曲线分析.
主要成果:
- 总共有604名SA-AKI患者被分析,其中14.5%的人经历了持续的严重SA-AKI.
- 在持久性严重SA-AKI (33.0 [24.0-45.5]) 与非持久性 (42.0 [31.0-53.0]) 患者中,HDL-C的中位数较低.
- HDL-C表现出差的区分能力 (AUROC:0.62 [0.56-0.69]). 没有任何的区分能力. 没有HDL-C的临床预测模型实现了高性能 (AUROC:0.876 [0.84-0.91]),而添加HDL-C并没有改善它.
结论:
- 在ICU入院后24小时内测量的血HDL-C水平不是持续严重SA-AKI的强有力的预测指标.
- HDL-C并没有提高已确定的临床变量的预测能力,用于性患者持续的SA-AKI.
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