预测心脏手术后术后心房动的系统性免疫炎症指数:一个元分析
Yu-Chou Chen1, Chien-Cheng Liu2,3,4, Hui-Chen Hsu5
1Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan.
Frontiers in cardiovascular medicine
|February 20, 2024
概括
系统性免疫炎症指数 (SII) 是心脏手术后术后心房动 (POAF) 风险的重要预测指标. 升高的SII增加了POAF的几率,表明其作为患者风险分层的有价值生物标志物的潜力.
科学领域:
- 心脏病学 心脏病学
- 手术并发症 手术并发症
- 生物标志物 生物标志物
背景情况:
- 手术后心房动 (POAF) 是心脏手术后的常见并发症,与增加的发病率和死亡率有关.
- 系统性免疫炎症指数 (SII) 由中性粒细胞,淋巴细胞和血小板数量得出的,是新兴的炎症生物标志物.
- 以前的研究表明,SII和POAF风险升高之间存在联系,但证据异构.
研究的目的:
- 系统地审查和分析现有证据,以预测心脏手术患者在POAF的外科手术期间SII的预测效果.
- 评估SII在预测POAF中的诊断准确性.
- 为了确定POAF的综合发病率和SII和POAF之间的关联.
主要方法:
- 在2023年8月进行了系统的文献搜索,以确定报告SII截止值,敏感性和特异性的研究.
- 使用元分析技术来综合包含的研究数据.
- 诊断实用程序使用分层总结接收器操作特征 (HSROC) 模型进行评估.
主要成果:
- 包括8项涉及3245名患者的研究,其中大多数集中在冠状动脉旁路移植 (CABG) 上.
- 聚合的POAF发生率为23.6%.
- 升高的SII与POAF的几率增加了3.24倍 (OR,3.24;p=0.001),聚合灵敏度为0.80和特异性为0.53.
- 在HSROC分析表明中等预测准确度 (AUC=0.78).
结论:
- 升高的SII与心脏手术后POAF风险增加有显著的相关性.
- 作为POAF的预测生物标志物,SII证明了它的实用性.
- 需要进一步的研究来澄清SII在风险分层方面的临床有效性,可能与其他因素结合.
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