炎症生物标志物和急性下肢缺血的结果:系统性审查和元分析
M A Lourdes Del Río-Solá1, Sergio Asensio-Rodriguez2, Sandra Pérez-Fernandez2
1Department of Surgery, Ophthalmology, Otorhinolaryngology, Physiotherapy, University Clinical Hospital of Valladolid, University of Valladolid, Miguel de Cervantes European University, Valladolid, Spain.
Annals of vascular surgery
|November 7, 2025
概括
炎症驱动急性下肢缺血 (ALLI) 的结果. 中性粒细胞与淋巴细胞的比率 (NLR) 是预测ALLI患者死亡率和截肢风险的关键生物标志物.
科学领域:
- 血管外科 血管外科
- 免疫学 免疫学 免疫学
- 生物标志物 生物标志物
背景情况:
- 急性下肢缺血 (ALLI) 是一种关键的血管紧急情况,具有失去肢体,残疾和死亡的高风险.
- 缺血后的炎症反应显著导致组织损伤和全身并发症.
研究的目的:
- 在ALLI中系统地审查和分析炎症机制,免疫路径,预后生物标志物和抗炎疗法.
- 综合目前关于炎症在ALLI病理生理学和预后中的作用的证据.
主要方法:
- 一个系统的审查和元分析,遵循PRISMA指南.
- 在PubMed,Embase,Cochrane图书馆和科学网上搜索了过去15年发表的关于ALLI炎症的研究.
- 包括ALLI的成年患者,重点关注炎症途径,生物标志物和疗法.
主要成果:
- 炎症途径,包括NLRP3炎症体,补充级联和细胞因子 (IL-1β,IL-6,TNF-α),驱动免疫细胞招募和组织损伤.
- 高中性粒细胞与淋巴细胞比率 (NLR) 是不良结果的强有力的预测指标;元分析显示30天死亡率或重大截肢的风险增加了3倍 (OR3.05).
- 向性抗炎药物显示出希望,但对皮质类固醇和TNF-α抑制剂的证据是不一致的.
结论:
- 炎症是ALLI发展和进展的组成部分.
- 在ALLI患者中,NLR是早期风险分层的可靠和可访问的生物标志物.
- 未来的治疗应该集中在个性化,生物标志物指导的抗炎策略,在强大的临床试验中.
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