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新冠病毒肺炎患者脂质谱改变及脂质在预测住院时间方面的价值

Alteration of lipid profile and value of lipids in the prediction of the length of hospital stay in COVID-19 pneumonia patients.

作者信息

Qin Chen, Minghan Huang, Ziwen Zhao, Yukun Luo

机构信息

Department of Cardiology Fujian Medical University Union Hospital Fuzhou China.

Fujian Institute of Coronary Artery Disease Fuzhou China.

出版信息

Food Sci Nutr. 2020 Oct 27;8(11):6144-6152. doi: 10.1002/fsn3.1907. eCollection 2020 Nov.

Abstract

To observe lipid profiles and their alterations in hospitalized patients with COVID-19 pneumonia (NCP) and evaluate the value of lipids for the prediction of the length of hospital stay (LOS), a total of 248 patients aged 18 years or older were enrolled in this retrospective study. At admission, the median levels of triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) in all patients were 1.11, 4.00, 0.89, and 2.11 mmol/L, respectively. Compared with common cases ( = 174), severe cases ( = 74) exhibited higher TG and HDL-C, and lower LDL-C. Levels of TC and LDL-C were negatively correlated with LOS. In 68 severe cases, serum lipids were followed up during hospitalization, and the median LOS was 29 days. The average levels of serum lipids were lowest at admission and gradually increased during hospitalization. Compared with the LOS ≤ 29 days group, serum levels of TC, HDL-C, and LDL-C were significantly lower in the LOS > 29 days group at admission; this lower trend was found in the subsequent tests for TC and LDL-C but not for HDL-C or TG. Multiple-variant COX regression showed that levels of TC or LDL-C at admission were independent risk of LOS prolongation. Together, these findings suggest that in patients with NCP, levels of TC and LDL-C at admission were negatively correlated with LOS. In severe cases, the gradual increase in TC, LDL-C, and HDL-C during hospitalization might indicate gradual recovery. TC < 3.75 mmol/L or LDL-C < 1.7 mmol/L at admission may act as an independent predictor of prolonged LOS.

摘要

为观察新型冠状病毒肺炎(NCP)住院患者的血脂谱及其变化,并评估血脂对预测住院时间(LOS)的价值,本回顾性研究共纳入248例18岁及以上患者。入院时,所有患者的甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)的中位数水平分别为1.11、4.00、0.89和2.11 mmol/L。与普通病例(n = 174)相比,重症病例(n = 74)的TG和HDL-C较高,而LDL-C较低。TC和LDL-C水平与LOS呈负相关。在68例重症病例中,住院期间对血脂进行了随访,中位LOS为29天。血脂的平均水平在入院时最低,并在住院期间逐渐升高。与LOS≤29天组相比,LOS>29天组入院时血清TC、HDL-C和LDL-C水平显著较低;在随后的TC和LDL-C检测中发现了这种下降趋势,但HDL-C或TG未发现。多变量COX回归显示,入院时TC或LDL-C水平是LOS延长的独立危险因素。总之,这些发现表明,在NCP患者中,入院时TC和LDL-C水平与LOS呈负相关。在重症病例中,住院期间TC、LDL-C和HDL-C的逐渐升高可能表明病情在逐渐恢复。入院时TC<3.75 mmol/L或LDL-C<1.7 mmol/L可能是LOS延长的独立预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d55/7684619/6ebeed3d4074/FSN3-8-6144-g001.jpg

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