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血浆生物标志物的入院值可预测急性主动脉夹层的短期预后。

Admission Values of Plasma Biomarkers Predict the Short-Term Outcomes in Acute Aortic Dissection.

机构信息

Emergency Department of West China Hospital, Sichuan University/West China School of Nursing, Sichuan University.

Institute of Disaster Medicine, Sichuan University

出版信息

Heart Surg Forum. 2021 Jan 19;24(1):E048-E054. doi: 10.1532/hsf.3417.

Abstract

BACKGROUND AND AIMS

Acute aortic dissection (AAD) is an emergency disease with high misdiagnosis rate and mortality. The aim of the present study is to explore the impact of blood-related biomarkers, specifically D-dimer, on in-hospital outcomes of patients with AAD.

MATERIALS AND METHODS

A total of 345 patients in our hospital from December 2013 to April 2017 were included. The cutoff value for D-dimer and LDL-C were set as 5.9mg/l and 1.45 mg/l, respectively. The univariate and multivariate logistic regression models were used to identify the independently prognostic predictors.

RESULTS

The results showed that patients with type A AAD had higher risk of in-hospital mortality compared with those with type B disease. Moreover, results revealed the type A AAD (OR 6.382, 95%CI: 2.423 to 16.812), D-dimer (OR 2.160, 95%CI: 1.072 to 4.350), and LDL-C (OR 0.373, 95%CI: 0.148 to 0.940) were independently associated with in-hospital mortality. Subgroup analysis suggested that D-dimer (OR 2.295, 95%CI: 1.140 to 4.622) was an independently prognostic factor in type A AAD.

CONCLUSION

In summary, D-dimer ≥5.9 mg/L and type A AAD were independently associated with in-hospital mortality in AAD patients. Moreover, subgroup analysis proved that the elevated D-dimer was related to poor prognosis in type A AAD.

摘要

背景与目的

急性主动脉夹层(AAD)是一种误诊率和死亡率均较高的急症。本研究旨在探讨血液相关生物标志物(尤其是 D-二聚体)对 AAD 患者住院结局的影响。

材料与方法

选取 2013 年 12 月至 2017 年 4 月我院收治的 345 例患者。将 D-二聚体和 LDL-C 的截断值分别设定为 5.9mg/L 和 1.45mg/L。采用单因素和多因素 logistic 回归模型来识别独立的预后预测因素。

结果

结果显示,与 B 型患者相比,A型 AAD 患者住院期间的死亡风险更高。此外,研究结果表明,A型 AAD(OR 6.382,95%CI:2.423 至 16.812)、D-二聚体(OR 2.160,95%CI:1.072 至 4.350)和 LDL-C(OR 0.373,95%CI:0.148 至 0.940)与住院期间的死亡率独立相关。亚组分析表明,D-二聚体(OR 2.295,95%CI:1.140 至 4.622)是 A 型 AAD 的独立预后因素。

结论

综上所述,D-二聚体≥5.9mg/L 和 A 型 AAD 与 AAD 患者的住院死亡率独立相关。此外,亚组分析证实,D-二聚体升高与 A 型 AAD 的不良预后相关。

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