一个新的指数来预测手术后的低血症在初级甲状腺功能障碍症
Ahmet Tarik Harmantepe1, Enes Bas1, Yesim Akdeniz2
1Department of General Surgery, Sakarya University Faculty of Medicine, Sakarya, Turkey.
Irish journal of medical science
|January 22, 2024
概括
手术前的ALP/Vit D比率是一个强有力的预测器,用于预测术后的甲状腺功能障碍症患者的低血症. 这个比率有助于识别风险较高的患者,特别是具有高骨周转率和维生素D缺乏症的患者.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 代谢性骨疾病 代谢性骨疾病
背景情况:
- 维生素D缺乏症在偏甲状腺功能障碍症患者中很普遍.
- 术前维生素D替代剂的作用受到争议.
- 高骨周转率可能会增加术后低血症的风险.
研究的目的:
- 调查手术前ALP/Vit D比率对于术后低血的预测值.
- 评估骨循环标记物与手术后低血症风险之间的关系.
主要方法:
- 对158名2015-2022年间经过手术的原发性偏甲状腺症患者的回顾性分析.
- 评估手术前的实验室结果,包括ALP和维生素D水平.
- 计算ALP/Vit D比率来预测术后低血症.
主要成果:
- 无变量分析确定了维生素D缺乏/不足,ALP,ALP/Vit D比率和T评分作为重要因素.
- 多变量分析证实了ALP/Vit D比率作为低血症的独立预测指标.
- 一个ALP/Vit D比>6.34与45倍增加的低血症的风险相关 (p<0.001).
- ALP/Vit D比率在预测低血症方面表现出87.2%的灵敏度和87.1%的特异性.
结论:
- 仅仅维生素D缺乏就不足以预测术后低血症.
- 手术前的ALP/Vit D比率是这些患者低血症风险的最强预测指标.
- 这一比率对于识别高骨周转率,风险较高的患者特别有价值.
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