高血清 P 物质水平与恶性大脑中动脉梗死患者的死亡率。

High serum substance P levels and mortality after malignant middle cerebral artery infarction.

机构信息

Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n. La Laguna, 38320 Santa Cruz de Tenerife, Spain.

Intensive Care Unit, Hospital Universitario Nuestra Señora de Candelaria, Crta del Rosario s/n, Santa Cruz de Tenerife 38010, Spain.

出版信息

J Crit Care. 2020 Jun;57:1-4. doi: 10.1016/j.jcrc.2020.01.022. Epub 2020 Jan 20.

DOI:10.1016/j.jcrc.2020.01.022

PMID:31991332

Abstract

PURPOSE

Previously our team found higher serum substance P concentrations at day 1 of a malignant middle cerebral artery infarction (MMCAI) in non-surviving than in surviving patients. Thus, the objective of this study was to determine whether serum substance P levels during the first week of MMCAI could predict mortality.

METHODS

We included patients with MMCAI defined as computed tomography findings of acute infarction in at least of 50% of the territory and Glasgow Coma Scale ≤8. We determined serum concentrations of substance P on days 1, 4 and 8 of MMCAI. Thirty-day mortality was the study end-point.

RESULTS

Serum substance P concentrations at days 1 (p < .001), 4 (p < .001), and 8 (p = .001) of MMCAI in non-surviving (n = 34) were higher than in surviving patients (n = 34). Receiver operating characteristic analyses showed that serum substance P concentrations at days 1, 4, and 8 of MMCAI had an area under curve (95% confidence intervals) to predict 30-day mortality of 0.77 (0.66-0.87; p < .001), 0.82 (0.69-0.91; p < .001) and 0.85 (0.72-0.94; p < .001) respectively.

CONCLUSIONS

The two new findings of our study are that non-surviving MMCAI patients showed higher serum substance P levels at day 1, 4 and 8 than surviving, and that those levels could predict 30-day mortality.

摘要

目的

此前，我们的团队发现，在恶性大脑中动脉梗死（MMCAI）发病第 1 天，非存活患者的血清 P 物质浓度高于存活患者。因此，本研究的目的是确定 MMCAI 发病第 1 周内的血清 P 物质水平是否可以预测死亡率。

方法

我们纳入了 MMCAI 患者，定义为计算机断层扫描发现至少 50%的区域有急性梗死，格拉斯哥昏迷量表≤8。我们在 MMCAI 发病第 1、4 和 8 天测定血清 P 物质浓度。30 天死亡率为研究终点。

结果

非存活组（n=34）发病第 1、4 和 8 天的血清 P 物质浓度（p<0.001）高于存活组（n=34）。受试者工作特征曲线分析显示，MMCAI 发病第 1、4 和 8 天的血清 P 物质浓度预测 30 天死亡率的曲线下面积（95%置信区间）分别为 0.77（0.66-0.87;p<0.001）、0.82（0.69-0.91;p<0.001）和 0.85（0.72-0.94;p<0.001）。