血清氨在非肝病危急患者的预后值:一个前性,观察性,多中心研究
Yue Li1, Zhipeng Yao1, Yunlong Li1
1Department of Intensive Care Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, Heilongjiang Province, China.
Journal of translational internal medicine
|December 22, 2023
概括
在没有肝病的重症监护室 (ICU) 患者中,平均氨水平升高与预后不佳有关. 在这种重症监护环境中,APACHE-II评分仍然是对患者结果最有预测力的因素.
科学领域:
- 关键护理医学 关键护理医学
- 神经学 神经学
- 临床生物化学 临床生物化学
背景情况:
- 非肝性高氨血症对中枢神经系统 (CNS) 构成风险.
- 在非肝性肺高血中,中枢神经系统损伤的预后因素尚未得到充分确立.
- 识别风险因素对于管理重症监护室 (ICU) 患者至关重要.
研究的目的:
- 为了研究患者的预后和风险因素被录取到ICU与非肝性高血.
- 确定氨水平与患者预后之间的关联.
- 为了比较各种临床评分和生物标志物的预测能力.
主要方法:
- 一项前性,观察性,多中心研究,涉及1060名ICU患者.
- 持续监测血液氨水平 (高,平均,初始).
- 进行了单变量,多变量逻辑回归和ROC曲线分析.
主要成果:
- 预后不佳与乳酸,总胆红素 (TBil) 和氨水平升高有关.
- 平均氨水平独立地与预后不佳有关 (OR = 1.73,P = 0.02).
- APACHE-II评分显示出最高的预测能力 (AUC = 0.714).
结论:
- 血清氨水平升高是ICU患者没有肝病的独立预后因素.
- 平均氨水平是糟糕结果的重要预测指标.
- 在这个患者群体中,APACHE-II评分仍然是预测预后的关键因素.
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