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作为术后全身炎症反应综合征和/或ICU多创伤患者的败血症预测性炎症标记的C-反应蛋白/白蛋白比率
Ahmed S Salem1, Mohamed A Zaghloul1, Alfred M Boctor1
1Department of Anesthesia and Intensive Care, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
概括
在多创伤患者中,C-反应蛋白与白蛋白比率 (CAR) 有效预测系统性炎症反应综合征 (SIRS) 和败血症. 这种简单的标记物,特别是在术后的第五天,有助于早期检测和干预,以获得更好的结果.
科学领域:
- 关键护理医学 关键护理医学
- 创伤外科 手术 创伤外科
- 生物标志物研究 生物标志物研究
背景情况:
- 多创伤患者面临系统性炎症反应综合征 (SIRS) 和败血症的高风险.
- 早期发现这些并发症对于改善患者的治疗结果至关重要.
- 现有的预测标记在这个复杂的患者群体中可能缺乏敏感性或特异性.
研究的目的:
- 评估C-反应蛋白与白蛋白比率 (CAR) 作为多创伤患者术后SIRS和败血症的预测标记.
- 评估CAR在这个人群中的时间变化和诊断准确性.
- 为了确定CAR是否可以作为一个早期,廉价的查工具.
主要方法:
- 进行了一项前性观察性研究,涉及100名多创伤患者入院于ICU.
- 测量C-反应蛋白 (CRP) 和白蛋白水平是在ICU入院和手术后的第1,3,5天.
- 计算和分析了CAR与SIRS和败血症发展的关联,使用ROC分析进行诊断准确性.
主要成果:
- 35%的患者出现了SIRS,28%的患者出现了败血症.
- 在SIRS阳性和败血症阳性患者中,在术后第1,3和第5天,CAR显著升高 (p < 0.001).
- 在第五天的CAR显示了SIRS (AUC:0.989) 和败血症 (AUC:0.934) 的高预测准确度.
结论:
- 逐渐升高的CAR是术后SIRS和多创伤患者的败血症的可靠早期预测因素.
- CAR可靠地预测SIRS和败血症,在术后第5天达到峰值.
- 该CAR作为一个有价值的,廉价的工具,用于早期风险分层和及时干预高风险多创伤患者.
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