血管的循环生物标志物:系统审查
Naomi Boyer1,2, Prateek Upadhyay3, Megan H Hicks4
1Intensive Care Unit, Royal Surrey NHS Foundation Trust, Guildford, UK. n.boyer@nhs.net.
血管,一种持续低血压的情况,缺乏标准化的定义和生物标志物. 本次审查强调氨酸和上腺素是有前途的候选药物,强调需要达成共识,以改善诊断和治疗.
科学领域:
- 关键护理医学 关键护理医学
- 心血管研究的心血管研究.
- 发现生物标志物的发现.
背景情况:
- 血管呈现为持续的低血压和低血管抵抗,通常在败血症和术后出现.
- 目前的诊断和治疗方法受到普遍定义和验证的生物标志物的缺失所阻碍.
- 关于血管的生物标志物的现有研究在不同的临床环境中是分散的.
研究的目的:
- 系统地审查和综合有关血管发病率,严重程度,预测和进展的循环生物标志物的证据.
- 评估现有文献中使用的血管的定义.
- 为了确定早期诊断和危险分层在重症监护和外科设置潜在的生物标志物.
主要方法:
- 在PROSPERO.上注册的PRISMA 2020指南的系统审查.
- 包括对患有血管的成年患者在重症监护或外科外科设置中的研究.
- 血管是由低血压和减少的血管抵抗所定义的,需要血管压缩剂.
主要成果:
- 包括43项研究,检查了39个不同的生物标志物.
- 列宁和上腺素是最常被研究的生物标志物.
- 蛋白升高与血管压缩剂需求相关;尽管定义和结果异质,但阿德伦米杜林预测了血管的发展和持续时间.
结论:
- 血管的定义和生物标志物测定中的显著异质性阻碍了比较分析.
- 雷宁和阿德里诺马杜林显示出希望,但迫切需要达成共识的定义,标准化的协议和统一的结果措施.
- 未来的研究应该优先考虑生物标志物引导的风险分层和针对各种血管现象的个性化疗法.
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