血D-二聚合物水平的预后值:一个前性队列研究
Xiaoxiao Qu1, Shishi Wang1, Xuanmei Ye1
1Department of Clinical Laboratory, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China.
Practical laboratory medicine
|September 2, 2025
概括
在入院时的血D-二聚合物水平预测了败血症患者的30天死亡率和败血症休克. 较高的D-二次数表明风险增加,有助于早期的败血症管理和风险分层.
科学领域:
- 危急护理医学
- 血液学
- 生物标志物
背景情况:
- 纤维素降解产物等离子体D-二聚体表明凝血激活,并且在危急病患者中经常升高.
- 对于毒症的短期结果,D- 模粒的预后价值尚未得到充分确立.
研究的目的:
- 调查血D二聚合物水平对患有败血症的成年ICU患者短期结局的预后意义.
- 确定D-二聚体是否可以作为败血症管理中的风险分层的早期生物标志物.
主要方法:
- 一项前性队列研究包括175名被诊断患有败血症的成年ICU患者 (败血症-3标准).
- 在ICU入院时和每天5天测量血D-二聚合物水平.
- 评估结果是使用考克斯回归和卡普兰- 梅尔分析分析的30天全因死亡率和住院感染性休克.
主要成果:
- 升高的D-二聚物水平与30天死亡率和败血症休克的风险显著增加.
- 每增加1微克/毫升的D-二聚合物与6%的死亡风险 (HR=1. 06) 和8%的败血症休克风险 (HR=1. 08) 相相关.
- 在最高的D-二分位数中,患者表现最差,D-二分位数与血清粉样蛋白A (SAA) 之间的死亡率显著相互作用.
结论:
- 血D-二聚合物水平可以独立预测毒症患者的30天死亡率和败血性休克.
- 在毒症管理中的风险分层中,D-二聚体具有价值的早期生物标志物.
- 进一步的研究可能会探索D-二聚体在治疗败血症的指导作用.
更多相关视频
相关概念视频
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
34
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
34
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
44
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
44
Venous Thrombosis III: Interprofessional Care
22
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
22
Blood Studies for Cardiovascular System I: Cardiac Biomarkers
332
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...
332
Pulmonary Embolism III: Nursing Management
37
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
37
Acute Kidney Injury IV: Diagnostic Studies and Prevention
57
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
57


