Ricart Antoni, Farrero Elisabet, Ventura Josep L, Javierre Casimiro, Carrió Lluïsa, Rodríguez David, Torrado Herminia, Ortiz Daniel
Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain.
Crit Care Med. 2009 Jul;37(7):2210-5. doi: 10.1097/CCM.0b013e3181a0321b.
To determine whether there are sex-based differences in serum troponin I (TnI) after cardiac surgery with cardiopulmonary bypass.
Prospective, observational, cohort study.
Tertiary cardiac surgery intensive care unit (ICU) at a university hospital.
None.
Serum TnI was measured in samples obtained at ICU admission and 6, 12, 24, and 48 hours later. A total of 761 consecutive patients were studied (444 men and 317 women). The characteristics and results of the different sex subgroups were as follows:A) Coronary bypass: 165 men and 38 women. Age, Parsonnet score, Acute Physiology and Chronic Health Evaluation III score, prevalence of renal failure, intra-aortic balloon use, and the lengths of cardiopulmonary bypass, mechanical ventilation, and ICU stay were similar in the two groups. Body mass index, red-cell transfusion needs, and use of noradrenaline were significantly higher in women, whereas dobutamine requirements were higher in men. Mortality: 3 men (1.6%) vs. 0 women (p = not significant).The TnI peak was slightly, but significantly, higher in men (6.2 +/- 4.9 vs. 4.5 +/- 2.6 microg/L. p < 0.05).B) Valve surgery: 279 men and 279 women. Some significant differences were found: Women were older than men and had higher Parsonnet score and transfusion needs. The other recorded variables were similar. Mitral prosthesis: 62 men and 125 women (p < 0.05). Mitral valvuloplasty: 24 men, 7 women (p < 0.05). Aortic prosthesis: 162 men, 103 women (p < 0.05). Mitral and aortic prosthesis: 31 men and 44 women (p < 0.05). TnI peaks were similar for both sexes in each valve subgroup. Mortality: 3 men (1%) vs. 11 women (3.4%) (p < 0.05).The TnI peak did not reach any significant differences between sexes (men 7.9 +/- 6.0 vs. 8.5 +/- 6.5 microg/L in women. p = not significant).
No clinically relevant sex-based differences were found in the TnI peaks after cardiac surgery.
确定体外循环心脏手术后血清肌钙蛋白I（TnI）是否存在性别差异。
前瞻性、观察性队列研究。
大学医院的三级心脏外科重症监护病房（ICU）。
无。
在ICU入院时以及之后6、12、24和48小时采集的样本中测量血清TnI。共研究了761例连续患者（444例男性和317例女性）。不同性别亚组的特征及结果如下：A）冠状动脉搭桥术：165例男性和38例女性。两组在年龄、Parsonnet评分、急性生理与慢性健康状况评估III评分、肾衰竭患病率、主动脉内球囊使用情况以及体外循环、机械通气和ICU住院时间方面相似。女性的体重指数、红细胞输血需求和去甲肾上腺素使用量显著更高，而男性的多巴酚丁胺需求量更高。死亡率：3例男性（1.6%）对0例女性（p = 无显著性差异）。男性的TnI峰值略高，但有显著差异（6.2±4.9对4.5±2.6μg/L，p < 0.05）。B）瓣膜手术：279例男性和279例女性。发现了一些显著差异：女性年龄大于男性，Parsonnet评分和输血需求更高。其他记录变量相似。二尖瓣置换术：62例男性和125例女性（p < 0.05）。二尖瓣成形术：24例男性，7例女性（p < 0.05）。主动脉瓣置换术：162例男性，103例女性（p < 0.05）。二尖瓣和主动脉瓣置换术：31例男性和44例女性（p < 0.05）。每个瓣膜亚组中两性的TnI峰值相似。死亡率：3例男性（1%）对11例女性（3.4%）（p < 0.05）。两性之间的TnI峰值未达到任何显著差异（男性7.9±6.0对女性8.5±6.5μg/L，p = 无显著性差异）。
心脏手术后TnI峰值未发现与临床相关的性别差异。
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