评估AKI 3风险因素和预测因素的新见解与式外科动脉置换相关
Anca Drăgan1, Adrian Ştefan Drăgan2
1Department of Cardiovascular Anaesthesiology and Intensive Care, "Prof. Dr. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, 258 Fundeni Road, 022328 Bucharest, Romania.
Diagnostics (Basel, Switzerland)
|September 13, 2025
概括
心脏手术后严重的急性损伤 (AKI) 与血液静止的重新干预,高的血管活性-无热积分 (VIS) 和低的淋巴细胞计数有关. 预测AKI 3的准确性在男性和女性大动脉置换手术患者之间有显著差异.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學.
- 外科手术的结果
背景情况:
- 经心脏手术后的急性损伤 (AKI),特别是动脉外科置换 (SAVR),带来了重大风险,包括慢性病,成本增加和死亡率.
- 识别严重的AKI (AKI 3) 风险因素和预测工具对于改善患者的治疗结果和临床管理至关重要.
- 在AKI预测中的性别差异需要进一步调查以个性化风险分层.
研究的目的:
- 在接受式SAVR的患者中确定严重AKI (AKI 3) 的独立风险因素.
- 评估炎症指数和AKI 3风险评分的预测意义.
- 分析AKI 3预测中的性别特异性差异.
主要方法:
- 在2022年至2024年期间,对422名在上接受SAVR的患者进行了回顾性分析.
- 多变量二进制物流回归以确定AKI的独立风险因素 3.
- 分析炎症指数 (系统性炎症反应指数,系统性炎症总指数,血小板与淋巴细胞比率) 和风险得分 (EuroSCORE,EuroSCORE II,塔卡尔得分) 用于AKI 3预测,重点关注性别差异.
主要成果:
- 121名患者 (28.67%) 经历了AKI,其中27名 (6.39%) 被归类为AKI 3.
- 独立的AKI 3风险因素包括血液静止的重新干预 (OR 9.76),早期的术后血管活性-无热性评分 (VIS) (OR 1.049),以及术后淋巴细胞计数 (OR 2.252).
- 与添加剂EuroSCORE相比,炎症指数和三角形PLR对女性AKI 3的预测更好,但不如EuroSCORE II准确. 塔卡尔得分预测AKI 3仅在男性中.
结论:
- 早期的术后VIS,淋巴细胞计数和血液静止再干预是SAVR患者严重AKI的独立风险因素.
- 在使用炎症标志物和风险评分预测AKI 3时,存在显著的基于性别的差异.
- 个性化监测和风险分层策略可能是必要的,考虑到患者的性别.
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