在2958名患者中探索D-乳酸盐作为急性肠死病的生物标志物:一项前性横截面研究
David Straarup1, Kåre A Gotschalck2, Peter A Christensen3
1Department of Gastrointestinal Surgery, Aalborg University Hospital, Aalborg, Denmark.
The Journal of emergency medicine
|March 31, 2024
概括
D-乳酸盐不是诊断急性肠死症 (AIN) 的可靠生物标志物. 谱光学分析受到脂质干扰的阻碍,限制了其用于AIN检测的临床实用性.
科学领域:
- 胃肠病学 胃肠病学
- 手术诊断手术诊断的使用方法
- 生物标志物研究 生物标志物研究
背景情况:
- 急性肠死症 (AIN) 诊断是关键的,但由于微妙的临床症状,具有挑战性.
- D-乳酸盐已被研究为AIN的潜在生物标志物.
研究的目的:
- 评估D-乳酸盐在临床环境中的诊断性能,用于急性肠道缩.
- 评估D-乳酸盐在中等风险和高风险患者群体中的有用性.
主要方法:
- 一项前性横截面研究招募了急性转诊患者和疑似AIN的高风险住院患者.
- 通过光谱光度测量进行AIN和D-乳酸盐分析的手术内验证.
- 接收器操作特征 (ROC) 曲线分析以确定D-乳酸切断和诊断性能 (AUC).
主要成果:
- 这项研究包括44名AIN患者和2914名对照人群;D乳酸切断值为0.0925毫米.
- 脂质干扰阻止了50%的患者的D-乳酸盐量化,将分析的队列减少到23名AIN患者和1456名对照.
- 对于AIN诊断,D-乳酸盐的敏感性较低 (0.261),AUC为0.588,在高风险患者中也有类似的结果 (AUC为0.579).
结论:
- 在平均和高风险人群中,D-乳酸盐对诊断AIN的敏感性较低.
- 脂质干扰显著影响光谱D-乳酸盐评估,质疑其作为AIN诊断标记物的临床适用性.
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