急性肝衰竭中的氨和尿素代谢:一个多中心队列研究
Filipe S Cardoso1,2, David Toapanta3, Natalia Jimenez3
1Transplant Unit, Intensive Care Unit, Nova Medical School, Curry Cabral Hospital, Lisbon, Portugal.
概括
在急性肝衰竭 (ALF) 中,较高的氨和较低的尿素水平与疾病严重程度有关. 使用氨的评分系统有效地预测了ALF患者的无移植生存率.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 关键护理医学 关键护理医学
- 生物化学 生物化学
背景情况:
- 氨的代谢以尿素发生在肝脏中.
- 氨水平与急性肝衰竭 (ALF) 的存活率相关.
- 尿素在ALF中的变化仍未得到充分研究.
研究的目的:
- 为了研究血清氨,尿素和ALF患者的结果之间的关联.
- 评估氨和尿素对无移植生存 (TFS) 和肝脏重量的预测值.
主要方法:
- 葡萄牙和西班牙ALF患者的观察队列研究 (10/2010-01/2023).
- 外部验证使用美国ALF研究小组队列.
- 主要暴露:入住ICU时的血清氨和尿素; 主要终点:30天的TFS; 二次终点:扩充肝脏体重.
主要成果:
- 更高的氨或更低的尿素与更高的INR在ICU入院时相关.
- 更高的氨量独立地与较低的30天TFS相关 (aOR 0.991; p=0.004).
- 基于氨的模型显示出良好的区分 (AUC 0.78) 和对TFS预测的校准.
- 在移植患者中,较高的氨或较低的尿素与较低的肝脏重量相关.
结论:
- 血清氨和尿素水平是ALF严重程度的重要指标.
- 包括血清氨在内的预测得分显示了ALF中TFS的合理准确性.
相关概念视频
02:24Comparative Excretory Systems
19.2K
Animals have evolved different strategies for excretion, the removal of waste from the body. Most waste must be dissolved in water to be excreted, so an animal’s excretory strategy directly affects its water balance.
19.2K
01:17Factors Affecting Renal Clearance: Renal Impairment
72
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
72
01:20Overview of Nitrogen Metabolism
7.9K
Nitrogen is a very important element for life because it is a major constituent of proteins and nucleic acids. It is a macronutrient, and in nature, it is recycled from organic compounds and stored in the form of ammonia, ammonium ions, nitrate, nitrite, or nitrogen gas by many metabolic processes. Many of these metabolic processes are carried out only by prokaryotes.
The largest pool of nitrogen available in the terrestrial ecosystem is gaseous nitrogen (N2) from the air, but this...
The largest pool of nitrogen available in the terrestrial ecosystem is gaseous nitrogen (N2) from the air, but this...
7.9K