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心脏手术患者围手术期SCD14-ST(可溶性髓系细胞触发受体-1)水平监测

[SCD14-ST (presepsin) level monitoring in cardiac surgical patients during perioperative period].

作者信息

Popov D A, Pliushch M G, Ovseenko S T, Abramian M V, Podshchekoldina O O, Iarustovskiĭ M B

出版信息

Anesteziol Reanimatol. 2013 May-Jun(3):30-5.

Abstract

UNLABELLED

Purpose of the study was to define prognostic ability of presepsin (sCD14-ST) as a predictor of complications in cardiac surgical patients during perioperative period.

METHODS

Patients operated for acquired heart valvular diseases with cardiopulmonary bypass were involved in the study (n = 51, age 58 +/- 11 years). Following parameters were studied; demographic data, duration of cardiopulmonary bypass, time of aorta clamping, severity-of-disease by APACHE II scale before surgery, on 1st, 2nd, 3rd and 6th day after surgery, routine clinical laboratory data and sCD14-ST.

RESULTS

there were no clinical laboratory evidences of inflammation before surgery in all patients. There was no difference between biomarkers in patients who had normal condition during postoperative period and in patients who had complications and/or untoward outcomes during postoperative period. Presepsin level in 6 patients (11.8%) was 543 (519-602) ng/ml, maximal 1597 ng/ml. Infection complications accrued in 19 patients (37%). Hospital mortality was 13.7% (7 patients), all cases of death was in group of patients with infection complications. Statistically significant differences in the level of presepsin and severity-of-disease by APACHE II in groups of patients with infection complications and without accrued on 1st and 2nd days of postoperative period. Optimal split point were 702 ng/ml, 8.5 points and 3.3 ng/ml. Increased postoperative level of presepsin is associated with a risk of infection complications and untoward outcomes.

CONCLUSION

sCD14-ST monitoring with the use of severity-of-disease scales and recent biomarkers allow to identify patients with high risk of infection complications and untoward outcomes.

摘要

未标注

本研究的目的是确定可溶性髓系细胞触发受体-1(sCD14-ST,即 presepsin)作为心脏手术患者围手术期并发症预测指标的预后能力。

方法

纳入行体外循环下后天性心脏瓣膜病手术的患者(n = 51,年龄 58±11 岁)。研究了以下参数;人口统计学数据、体外循环时间、主动脉阻断时间、术前、术后第 1、2、3 和 6 天的急性生理与慢性健康状况评分系统 II(APACHE II)疾病严重程度评分、常规临床实验室数据和 sCD14-ST。

结果

所有患者术前均无临床实验室炎症证据。术后情况正常的患者与术后有并发症和/或不良结局的患者之间生物标志物无差异。6 例患者(11.8%)的 presepsin 水平为 543(519 - 602)ng/ml,最高为 1597 ng/ml。19 例患者(37%)发生感染并发症。医院死亡率为 13.7%(7 例患者),所有死亡病例均在感染并发症患者组中。术后第 1 天和第 2 天,有感染并发症组和未发生感染并发症组的 presepsin 水平和 APACHE II 疾病严重程度评分存在统计学显著差异。最佳分界点分别为 702 ng/ml、8.5 分和 3.3 ng/ml。术后 presepsin 水平升高与感染并发症和不良结局风险相关。

结论

结合疾病严重程度评分系统和近期生物标志物监测 sCD14-ST,有助于识别感染并发症和不良结局高风险患者。

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