肌球蛋白水平的动态增加与重症患者的预后不佳有关:一项回顾性队列研究
Yishan Liu1,2, Jinlong Jiang1,2, Hao Yuan1,2
1Department of Critical Care Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
在重症患者中,动态监测肌球蛋白水平可以预测预后. 快速上升的肌球蛋白轨迹与更高的死亡率有关,突出了其在重症监护室 (ICU) 患者评估中的价值.
科学领域:
- 关键护理医学 关键护理医学
- 生物标志物发现发现
- 预测建模的预测建模
背景情况:
- 肌球蛋白是重症患者的公认生物标志物.
- 肌球蛋白水平的动态变化及其预后影响在很大程度上仍未被描述.
研究的目的:
- 在重症患者中调查肌红蛋白水平动态的预后价值.
- 识别不同的肌球蛋白轨迹及其与患者结果的关联.
主要方法:
- 追溯分析了11,218名来自ICU的危急病患者.
- 排除患有急性心血管事件,重大手术或狂犬病的患者.
- 隐性类轨迹建模 (LCTM) 用于将患者分类为肌球蛋白水平组.
- 在确定的轨迹中比较特征和结果 (住院和28天死亡率).
- 敏感性分析和受限平均生存时间回归用于结果评估.
主要成果:
- 在56.5%的患者中观察到肌球蛋白升高 (≥150 ng/mL);死亡率在1000μg/mL以上显著增加.
- LCTM确定了四个轨迹:稳定,逐渐下降,缓慢上升和快速上升.
- 快速上升的肌球蛋白组显示出最高的败血症比例 (59.6%),SOFA得分 (10) 和住院死亡率 (74.5%).
- 快速和缓慢上升的肌球蛋白轨迹与28天生存时间的缩短显著相关.
结论:
- 肌球蛋白升高在ICU患者中很普遍,其动态监测有助于预后.
- 独特的肌球蛋白轨迹为患者的治疗结果和死亡风险提供了宝贵的见解.
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