新型系统性炎症标志物预测患者进行内血管腹腔大动脉动脉瘤修复的全因死亡率
Wen-Xin Zhao1,2, Zhi-Yuan Wu1, Ning Zhao1,2
1Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 100010 Beijing, China.
Reviews in cardiovascular medicine
|July 30, 2024
概括
较高的中性粒细胞与淋巴细胞比率 (NLR) 和较低的血红蛋白与红细胞分布宽度比率 (HRR) 预测在接受内血管腹腔大动脉瘤 (EVAR) 修复的患者中,长期生存率不佳. 这些全身炎症标志物 (SIM) 可能有助于对EVAR程序的风险分层.
科学领域:
- 血管外科 血管外科
- 心血管医学 心血管医学
- 炎症标记物 炎症标记物
背景情况:
- 血管内动脉瘤 (EVAR) 程序的风险分层需要临床上有用的长期生存预测指标.
- 系统性炎症标志物 (SIMs) 是新的指标,可能在EVAR患者中具有预后意义.
研究的目的:
- 分析术前新型SIM对接受EVAR的患者长期死亡率的预后意义.
- 调查中性粒细胞与淋巴细胞比率 (NLR),血小板与淋巴细胞比率 (PLR),血红蛋白与红细胞分布宽度比率 (HRR),全身免疫炎症指数 (SIII) 和全身炎症反应指数 (SIRI) 在 EVAR 中的预测值.
主要方法:
- 对147名接受首次EVAR手术的患者进行了回顾性分析.
- 使用接收器运行特征 (ROC) 曲线来确定死亡率预测的门值.
- 采用卡普兰-梅尔生存分析和多变量考克斯回归来评估SIM与长期死亡率之间的关系.
主要成果:
- 患有较高NLR和较低HRR的患者的死亡率明显较高 (p < 0.001).
- 卡普兰-梅尔分析显示,在高NLR (NLR>2.77) 和低HRR (HRR <10.64) 组中,死亡率明显增加.
- 多变量分析确定了手术前HRR降低作为EVAR后增加死亡率的独立风险因素 (HR = 0.833,p = 0.021).
结论:
- 手术前升高的NLR和降低的HRR与接受腹腔大动脉瘤 (AAA) EVAR的患者的长期存活率较低有关.
- 术前HRR降低是EVAR后死亡风险增加的独立预测因素.
- 像NLR和HRR这样的SIM显示了对接受EVAR的AAA患者未来临床风险预测的潜力,这需要进一步的前性研究.
相关概念视频
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
69
Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
69
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
128
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
128