血中细胞外粒子度升高预测严重创伤后医院内死亡率
Nils Becker1, Niklas Franz2, Akiko Eguchi3
1Department of Trauma, Hand, Plastic and Reconstructive Surgery, Translational and Experimental Trauma Research, Ulm University Medical Center, Ulm, Germany.
Frontiers in immunology
|June 27, 2024
概括
在创伤患者中细胞外颗粒 (EP) 的升高预测死亡率. 早期测量循环EP可以帮助识别有风险的个体,并指导严重伤害的治疗决策.
科学领域:
- 创伤和紧急医疗医学
- 生物标志物和诊断方法
- 细胞和分子生物学 细胞和分子生物学
背景情况:
- 细胞外颗粒 (EPs),包括细胞外囊泡,与创伤后免疫失调有关.
- EPs携带特定的标记物和调节分子,表明它们作为器官损伤和患者预后的早期诊断指标的作用.
- 识别有风险的创伤患者和指导治疗干预需要可靠和可访问的生物标志物.
研究的目的:
- 评估循环细胞外颗粒 (EPs) 在预测严重受伤多重创伤患者的结果中的早期诊断价值.
- 评估EP作为生物标志物的潜力,以识别患有创伤后并发症和死亡风险的患者.
主要方法:
- 在急诊室到达时,从133名严重受伤的创伤患者 (伤害严重性评分≥16) 收集了血样本.
- 分析了循环EPs (<200nm),细胞因子概况和血液细胞计数 (血小板,白细胞).
- 进行了接收器操作特征 (ROC) 分析,以确定诊断准确度以预测死亡率.
主要成果:
- 与幸存者相比,非幸存者的循环EP数量 (<200nm) 显著更高,尽管受伤模式相似.
- 一个EP切断17380/μl血表明77%的灵敏度和61%的特异性预测在医院死亡率.
- 没有幸存者的乳酸盐水平较高,血小板数量较低,并在抵达时接受了更多的输血.
结论:
- 循环PE的度升高 (<200nm) 显示出重要的诊断潜力,用于识别严重创伤后死亡风险的患者.
- EP测量提供了与已确立的临床预测死亡率可比的灵敏度.
- 早期评估EP度可以增强现有的标志物,以指导创伤护理中的及时治疗决策.
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