开发和评估一种创新的炎症预后评分,用于预测肺栓塞患者的长期死亡率
Ning Zhu1,2, Lei Zhang3, Jiabao Wu1
1Department of Respiratory and Critical Care Medicine, Fujian Medical University Union Hospital, Fuzhou, Fujian, China, fjmu.edu.cn.
Mediators of inflammation
|January 7, 2026
概括
一个新的炎症预后得分 (IPS) 有效地预测肺栓塞 (PE) 患者的长期死亡率. 这个得分,使用五个常见的生物标志物,改善风险分层超越传统的临床因素.
科学领域:
- 生物标志物和炎症研究研究
- 心血管医学 心血管医学
- 肺部医学 肺部医学
背景情况:
- 系统性炎症是肺栓塞 (PE) 中不良结果的已知危险因素.
- 预测急性PE患者的长期死亡率对于有效管理至关重要.
- 现有的预后工具可能无法完全捕捉炎症标志物的影响.
研究的目的:
- 开发和验证一种新的炎症预后评分 (IPS).
- 评估IPS对急性PE患者长期全因死亡率的预测价值.
- 为了确定IPS是否在与临床预测因素相结合时增强风险分层.
主要方法:
- 对1642名急性PE患者进行了回顾性队列研究.
- 对15种炎症生物标志物的分析,包括C反应蛋白 (CRP),白细胞计数 (WBC) 和像系统性免疫炎症指数 (SII) 这样的衍生指数.
- 使用LASSO考克斯回归构建IPS,通过生存分析,考克斯回归,ROC分析和随机生存森林 (RSF) 评估预后性能.
主要成果:
- 在43.87个月的中位数随访期间,16.0%的患者死亡.
- 开发的IPS (0.395×IBI + 0.236×RDW + 0.208×SIRI + 0.115×MLR + 0.040×CRP) 与死亡率有显著的相关性 (aHR=2.55).
- 当IPS被添加到临床模型中时,它将3年AUC从0.820提高到0.886,显示出优越的风险分层.
结论:
- 由五种易于获得的炎症生物标志物衍生出的IPS是急性PE中长期死亡率的独立预测指标.
- IPS显著提高了风险分层,超出了传统的临床因素.
- 这一分数为早期预后评估和PE患者个性化治疗策略提供了潜力.
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