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降钙素原和白细胞介素-6水平升高与心脏手术术后并发症相关。

Elevated Levels of Procalcitonin and Interleukin-6 are Linked with Postoperative Complications in Cardiac Surgery.

作者信息

Brocca A, Virzì G M, de Cal M, Giavarina D, Carta M, Ronco C

机构信息

1 IRRIV-International Renal Research Institute of Vicenza, Vicenza, Italy.

2 Department of Nephrology, Dialysis and Transplantation, San Bortolo Hospital, Vicenza, Italy.

出版信息

Scand J Surg. 2017 Dec;106(4):318-324. doi: 10.1177/1457496916683096. Epub 2017 Mar 1.

Abstract

BACKGROUND

Cardiac surgery-associated acute kidney injury is a frequent and serious postoperative complication of cardiac surgery and is associated with an increased risk of morbidity, mortality, and length stay. In this study, we hypothesized that persistent elevation in inflammation in the first 48 h might be a powerful predictor of clinical outcome. Our aim was to elucidate the usefulness of interleukin-6 and procalcitonin postoperative levels in predicting mortality and renal complications in cardiac surgery patients.

METHODS

A total of 122 cardiac surgery patients were enrolled. Procalcitonin and interleukin-6 concentrations were measured on the second postoperative day, and their levels were evaluated versus a number of conditions and endpoints.

RESULTS

Procalcitonin has a good predictive value for adverse renal outcome (p < 0.05). Interleukin-6 has a good predictive value for 30 days and overall mortality in cardiac surgery population (p < 0.05). We did not observe a significant difference in procalcitonin and interleukin-6 levels among patients with different types of surgery and different extracorporeal circulation time, but the levels of both the molecules increase significantly depending on number of transfusions received by patients (p < 0.01).

CONCLUSION

We speculated that procalcitonin and interleukin-6 could be two effective biomarkers. There is a possibility of having a combined inflammatory multi-biomarker panel, with procalcitonin for predicting renal outcome and interleukin-6 for predicting mortality.

摘要

背景

心脏手术相关急性肾损伤是心脏手术后常见且严重的并发症,与发病率、死亡率增加及住院时间延长相关。在本研究中,我们假设术后48小时内炎症持续升高可能是临床结局的有力预测指标。我们的目的是阐明白细胞介素-6和降钙素原术后水平在预测心脏手术患者死亡率和肾脏并发症方面的作用。

方法

共纳入122例心脏手术患者。在术后第二天测量降钙素原和白细胞介素-6浓度,并根据多种情况和终点对其水平进行评估。

结果

降钙素原对不良肾脏结局具有良好的预测价值(p < 0.05)。白细胞介素-6对心脏手术人群的30天死亡率和总体死亡率具有良好的预测价值(p < 0.05)。我们未观察到不同手术类型和不同体外循环时间的患者之间降钙素原和白细胞介素-6水平存在显著差异,但这两种分子的水平均随患者输血次数的增加而显著升高(p < 0.01)。

结论

我们推测降钙素原和白细胞介素-6可能是两种有效的生物标志物。有可能形成一个联合炎症多生物标志物组合,其中降钙素原用于预测肾脏结局,白细胞介素-6用于预测死亡率。

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