心脏生物标志物用于查和预测危急病患者心脏功能障碍的预后
Oscar Cavefors1,2, Freyr Einarsson1, Jakob Holmqvist1,2
1Department of Anaesthesiology and Intensive Care Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
高灵敏度的热素T (hsTNT) 和N终端前脑尿性 (NT-proBNP) 与ICU患者的心脏功能障碍相关,并预测死亡率. 然而,它们的低特异性使得它们不适合用于查目的.
科学领域:
- 心脏病学 心脏病学
- 密集护理医学 密集护理医学
- 生物标志物研究 生物标志物研究
背景情况:
- 心脏功能障碍在重症监护室 (ICU) 患者中很常见.
- 早期发现心脏功能障碍对于患者的治疗和治疗结果至关重要.
研究的目的:
- 为了评估高灵敏度的托罗T (hsTNT) 和N-终端前脑尿性 (NT-proBNP) 在混合ICU人群中查心脏功能障碍.
- 确定这些生物标志物是否独立地与90天死亡率的增加有关.
主要方法:
- 一项涉及276名ICU患者的前性观察性研究的二次分析.
- 跨胸腔心声学 (TTE) 用于评估心脏功能.
- 使用回归模型测量hsTNT和NT-proBNP水平,并与TTE发现和死亡率相关联.
主要成果:
- 64%的患者在TTE时表现出心脏功能障碍.
- 与正常功能患者相比,心脏功能障碍患者的hsTNT和NT-proBNP水平显著更高.
- 生物标志物水平独立地与90天死亡率的增加有关 (hsTNT的P=0.048,NT-proBNP的P<0.006).
结论:
- hsTNT和NT-proBNP与ICU患者的心脏功能障碍和死亡率有很强的相关性.
- 尽管存在相关性,但它们的低负预测值和临床相关敏感度水平的特异性使得它们不能作为心脏功能障碍的查工具.
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