C反应蛋白/白蛋白比值在预测Stanford B型急性主动脉夹层患者术前氧合障碍发生中的价值

Value of C-reactive protein/albumin ratio in predicting the development of preoperative oxygenation impairment in patients with Stanford type-B acute aortic dissection.

作者信息

Zhao Xuemin, Bie Mengjun

机构信息

Department of Cardiology, The First Branch Hospital of The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.

Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.

出版信息

Int J Cardiol Heart Vasc. 2024 Jan 11;50:101337. doi: 10.1016/j.ijcha.2024.101337. eCollection 2024 Feb.

DOI:10.1016/j.ijcha.2024.101337

PMID:38282751

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10821624/

Abstract

OBJECTIVES

We aimed to assess the predicting value of C-reactive protein (CRP)/albumin ratio (CAR) in the development of Oxygenation impairment (OI) in the patients with Stanford type-B acute aortic dissection (AAD).

METHODS

This study included 133 patients (age = 58.8 ± 12.0 years, median age = 61 years, Male/Female = 117/16) diagnosed as Stanford type-B AAD accompanied by hypertension from July 2012 to May 2020. Clinical data were retrospectively extracted from the database. The patients in this study were divided into OI group (oxygenation index ≤ 200) and non-OI group (oxygenation index > 200). Clinical characteristics in both groups were compared, and predicting value of CAR in the development of OI was assessed.

RESULTS

Patients in OI group had higher peak body temperature (37.94 ± 0.62 vs. 37.67 ± 0.51 ℃, =.010), higher levels of serum CRP (41.74 ± 27.71 vs 15.21 ± 19.66 mg/L, =.000) and plasma B-type natriuretic peptide (292.14 ± 251.11 vs 179.80 ± 241.27 ng/L, =.016), lower levels of albumin (34.00 ± 5.14 vs 37.72 ± 5.24 g/L, =.000), and higher CAR (1.27 ± 0.89 vs 0.41 ± 0.53, =.000). In multivariate regression analysis, CAR (odds ratio: 5.215, 95 % CI: 2.682; 10.137, =.000) and the peak body temperature (odds ratio: 2.905, 95 % CI: 1.255; 6.724, =.013) could significantly predict the OI development. The AUC for CAR was 0.831 (95 % CI: 0.756-0.907). An optimal cutoff value for CAR for predicting OI was ≥ 0.70, with a sensitivity of 67.5 % and a specificity of 88.2 %.

CONCLUSIONS

Compared with CRP or albumin alone, the CAR might be a more accurate marker in predicting OI development in Stanford type-B AAD.

摘要

目的

我们旨在评估C反应蛋白（CRP）/白蛋白比值（CAR）对斯坦福B型急性主动脉夹层（AAD）患者氧合障碍（OI）发生的预测价值。

方法

本研究纳入了2012年7月至2020年5月期间诊断为伴有高血压的斯坦福B型AAD的133例患者（年龄=58.8±12.0岁，中位年龄=61岁，男/女=117/16）。临床数据从数据库中进行回顾性提取。本研究中的患者被分为OI组（氧合指数≤200）和非OI组（氧合指数>200）。比较两组的临床特征，并评估CAR对OI发生的预测价值。

结果

OI组患者的体温峰值更高（37.94±0.62 vs. 37.67±0.51℃，P=0.010），血清CRP水平更高（41.74±27.71 vs 15.21±19.66mg/L，P=0.000），血浆B型利钠肽水平更高（292.14±251.11 vs 179.80±241.27ng/L，P=0.016），白蛋白水平更低（34.00±5.14 vs 37.72±5.24g/L，P=0.000），CAR更高（1.27±0.89 vs 0.41±0.53，P=0.000）。在多因素回归分析中，CAR（比值比：5.215，95%置信区间：2.682；10.137，P=0.000）和体温峰值（比值比：2.905，95%置信区间：1.255；6.724，P=0.013）可显著预测OI的发生。CAR的曲线下面积为0.831（95%置信区间：0.756-0.907）。预测OI的CAR最佳截断值为≥0.70，敏感性为67.5%，特异性为88.2%。