在急性腹部-A前性观察研究中检测外科紧急情况的生物标志物
Claudine A Blum1,2, Matthieu Faron3,4, Anne Laure Paquet1
1Service d'Accueil des Urgences, GH Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, Paris, France.
The journal of applied laboratory medicine
|November 5, 2025
概括
在紧急情况下,白细胞和中性粒细胞计数,C反应蛋白 (CRP) 和前素显示出在急性腹痛患者中确定外科紧急情况的希望. 压力生物标志物,如可佩和皮质醇,并不是有效的预测因素.
科学领域:
- 紧急医疗 紧急医疗
- 临床生物化学 临床生物化学
- 手术诊断手术诊断的使用方法
背景情况:
- 急性腹痛在紧急情况下是一个重大的诊断挑战.
- 及时识别手术紧急情况对于患者的治疗结果至关重要.
- 生物标志物可能有助于区分手术紧急情况与其他引起腹痛的原因.
研究的目的:
- 评估炎症和压力生物标志物的诊断价值,以确定急性腹痛患者的外科紧急情况.
- 为了比较各种生物标志物的预测性能,包括可佩,皮质醇,公素,IL-6,CRP和细胞计数.
主要方法:
- 对304名急诊科急性腹痛患者进行前性观察性研究.
- 在呈现和4小时后测量素,皮质醇,前素,IL-6,CRP,白细胞和中性细胞计数.
- 2周后通过电话进行跟踪,以确定诊断和结果.
主要成果:
- 在46名 (15%) 患者中发现了外科紧急情况.
- 白血球和中性粒细胞计数显示了外科紧急情况的良好预测值 (AUC 0.75).
- C-反应蛋白 (CRP) 和前素表现平,而IL-6,素和皮质醇并不是有用的预测因素.
- 一个递归分区模型将CRP确定为预测外科紧急情况的最相关的生物标志物.
结论:
- 压力生物标志物科佩和皮质醇在识别外科紧急情况方面并不有效.
- 最初的白细胞和中性粒细胞计数,CRP和前素对于识别急性腹部手术紧急情况是有价值的.
- 在4小时测量后的IN-6 (IL-6) 在识别外科紧急情况方面也显示出潜在的实用性.
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