血生物活性上腺素可以预测COVID-19危急病例的死亡率和透析需要
Patrik Johnsson1,2, Theodor Sievert3,4, Ingrid Didriksson3,4
1Department of Clinical Medicine, Anaesthesiology and Intensive Care, Lund University, 22185, Lund, Sweden. patrik.johnsson@med.lu.se.
Scientific reports
|October 11, 2024
概括
在COVID-19患者中,腺素 (生物-ADM) 水平预测死亡率和透析需求. 随着时间的推移,生物ADM的变化是患者结果和潜在治疗目标的关键指标.
科学领域:
- 关键护理医学 关键护理医学
- 内分泌学 在内分泌学.
- 传染性疾病 传染性疾病
背景情况:
- COVID-19导致严重的呼吸系统疾病,死亡率高.
- 腺素 (生物-ADM),一种血管活性激素,调节内皮屏障功能.
- 生物ADM与COVID-19患者的不良结果有关.
研究的目的:
- 调查上腺素 (生物-ADM) 水平与COVID-19重症监护室 (ICU) 患者的治疗结果之间的关联.
- 评估生物ADM对90天死亡率和急性损伤 (AKI) 的预测价值.
- 探索生物ADM作为患者选和治疗向的潜在生物标志物.
主要方法:
- 对119名连续入住ICU的COVID-19患者进行前性队列试点研究.
- 在ICU入院时,第二天和第七天,对血生物ADM水平的回顾性分析.
- 生存分析和后勤回归用于分析生物ADM与结果之间的关联,调整临床因素.
主要成果:
- 入院时和第二天和第七天的生物ADM水平适度预测了90天的死亡率.
- 在第2天和第7天之间生物ADM的相对变化是死亡率的更强的预测因素 (HR1.09).
- 第二天的生物ADM强烈预测了需要替代疗法 (HR 3.18) 的需要,并与早期的AKI有关.
结论:
- 生物ADM水平及其变化是COVID-19患者死亡率和透析需求的重要预测因素.
- 生物ADM在COVID-19病理生理学中起着至关重要的作用,特别是在内皮屏障功能和损伤方面.
- 生物ADM显示出作为风险分层的生物标志物以及在严重的COVID-19中作为新型临床干预的目标的潜力.
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