在斯坦福大学A型大动脉剖析手术后,呼吸机相关肺炎的传染性标记物的早期预测值
Huibiao Deng1, Xiaohong Wu2, Bo Peng3
1Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, 201620 Shanghai, China.
Reviews in cardiovascular medicine
|March 3, 2025
概括
在大动脉剖析手术后,可以使用传染性标志物早期检测呼吸机相关性肺炎 (VAP). 预热素 (PCT),C反应蛋白 (CRP),中性粒细胞/淋巴细胞比率 (NLR) 和唾液涂抹可以预测VAP的发展.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 呼吸机相关肺炎 (VAP) 是心脏手术后的一个严重并发症.
- 斯坦福A型大动脉剖析需要复杂的手术管理,通常涉及机械通风.
- 早期识别VAP对于及时干预和改善患者结果至关重要.
研究的目的:
- 评估VAP的特定传染性标记物的早期预测值.
- 评估前素 (PCT),C反应蛋白 (CRP),中性粒细胞/淋巴细胞比率 (NLR) 和唾液涂抹的诊断准确性.
- 为了确定这些标记物的实用性,在接受斯坦福A型大动脉剖析手术的患者中.
主要方法:
- 对139名在斯坦福A型大动脉剖析手术后接受机械通风的患者进行了回顾性审查.
- 在VAP感染和非感染组之间的临床数据的比较.
- 接收器操作特征 (ROC) 曲线分析,以评估PCT,CRP,NLR和唾液涂抹的预测值.
主要成果:
- VAP发生率为25.18% (35个案例).
- 在VAP感染组中观察到显著升高的CRP,PCT和NLR水平 (p <0.05).
- 在ROC曲线下的面积 (AUC) 为PCT的0.835,NLR的0.763,CRP的0.820和唾液涂抹的0.745;综合AUC为0.923. 格拉姆阴性细菌是VAP的主要原因.
结论:
- 结合NLR,CRP,PCT和唾液涂抹的应用有助于早期VAP诊断大动脉剖析手术后.
- 这些标记物有助于临床医生迅速做出VAP治疗决策.
- 早期发现VAP可以改善高风险手术患者的管理策略.
关键词:
在C-反应性蛋白 (CRP) 中.斯坦福A型大动脉剖析中性粒细胞/淋巴细胞比 (NLR)这种药物被称为PCT (prokalcitonin).唾液涂抹是为了检查唾液.与呼吸机相关的肺炎 (VAP)更多相关视频
相关概念视频
Pneumonia III: Complications and Assessment
140
Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
140
Pneumonia I: Introduction
201
Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
201
Sensitivity, Specificity, and Predicted Value
158
In healthcare diagnostics, laboratory tests play a crucial role in identifying and diagnosing a wide range of medical conditions. However, interpreting test results is not always straightforward. An abnormal test result does not always confirm the presence of a disease, just as a normal result does not guarantee its absence. To assess the reliability of these diagnostic tools, healthcare practitioners rely on two key statistical indicators: sensitivity and specificity.
Sensitivity is the...
Sensitivity is the...
158


