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危重症 COVID-19 患者的内皮生物标志物:透析需求的潜在预测因子。

Endothelial Biomarkers in Critically Ill COVID-19 Patients: Potential Predictors of the Need for Dialysis.

机构信息

Medical Sciences Postgraduate Program, Department of Internal Medicine, School of Medicine, Universidade Federal do Ceará, Fortaleza, Brazil.

Instituto José Frota (IJF) Hospital, Fortaleza, Brazil.

出版信息

Kidney Blood Press Res. 2024;49(1):27-37. doi: 10.1159/000535035. Epub 2023 Nov 28.

Abstract

INTRODUCTION

The aim of this was to evaluate the function of vascular biomarkers to predict the need for hemodialysis in critically ill patients with COVID-19.

METHODS

This is a prospective study with 58 critically ill patients due to COVID-19 infection. Laboratory tests in general and vascular biomarkers, such as VCAM-1, syndecan-1, angiopoietin-1, and angiopoietin-2, were quantified on intensive care unit (ICU) admission.

RESULTS

There was a 40% death rate. VCAM and Ang-2/Ang-1 ratio on ICU admission were associated with the need for hemodialysis. Vascular biomarkers (VCAM-1, syndecan-1, angiopoietin-2/angiopoietin-1 ratio) were predictors of death and their cutoff values were useful to stratify patients with a worse prognosis. In the multivariate cox regression analysis with adjusted models, VCAM-1 (OR 1.13 [CI 95%: 1.01-1.27]; p = 0.034) and Ang-2/Ang-1 ratio (OR 4.87 [CI 95%: 1.732-13.719]; p = 0.003) were associated with the need for dialysis.

CONCLUSION

Vascular biomarkers, mostly VCAM-1 and Ang-2/Ang-1 ratio, showed better efficiency to predict the need for hemodialysis in critically ill COVID-19 patients.

摘要

介绍

本研究旨在评估血管生物标志物在预测 COVID-19 危重症患者需要血液透析中的作用。

方法

这是一项前瞻性研究,纳入了 58 例因 COVID-19 感染而入住重症监护病房(ICU)的危重症患者。在 ICU 入院时,对一般实验室检查和血管生物标志物(如 VCAM-1、 syndecan-1、血管生成素-1 和血管生成素-2)进行定量检测。

结果

患者死亡率为 40%。ICU 入院时的 VCAM 和 Ang-2/Ang-1 比值与血液透析的需求相关。血管生物标志物(VCAM-1、 syndecan-1、血管生成素-2/血管生成素-1 比值)是死亡的预测因子,其截断值可用于对预后较差的患者进行分层。在多变量 COX 回归分析中,调整模型后,VCAM-1(OR 1.13 [95%CI:1.01-1.27];p = 0.034)和 Ang-2/Ang-1 比值(OR 4.87 [95%CI:1.732-13.719];p = 0.003)与血液透析的需求相关。

结论

血管生物标志物,尤其是 VCAM-1 和 Ang-2/Ang-1 比值,在预测 COVID-19 危重症患者血液透析需求方面显示出更好的效率。

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