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2型心肾综合征的预测指标与预后模型:一项多中心回顾性研究

Predictor and prognostic modeling in cardiorenal syndrome type 2: a retrospective study of multicenter.

作者信息

Wang Bin, Zheng Xie, Fu Qinghui, Luo Xiaoqian, Pan Sijun

机构信息

The Department of Emergency, People's Hospital of Anji, Anji, Zhejiang, China.

The Department of SICU, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.

出版信息

Biomark Med. 2025 Jun;19(12):491-499. doi: 10.1080/17520363.2025.2520738. Epub 2025 Jun 16.

DOI:10.1080/17520363.2025.2520738
PMID:40521649
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12184174/
Abstract

BACKGROUND

Type 2 CRS is characterized by the development of renal dysfunction secondary to chronic cardiac disease. Despite its high morbidity and mortality, there is a lack of robust diagnostic tools and prognostic models to guide clinical management.

METHODS

This multicenter retrospective study included patients diagnosed with CRS type 2 based on the 2019 American Heart Association definition. Data were collected from electronic medical records of three hospitals between January 2021 and December 2023. Advanced statistical methods, including receiver operating characteristic (ROC) curve analysis, univariate Kaplan-Meier (KM) analysis, and multivariable Cox proportional hazards regression, were utilized to develop a nomogram for predicting patient prognosis.

RESULTS

The study included 519 patients with CRS-2. Independent predictors of adverse outcomes included elevated serum creatinine and blood urea nitrogen (BUN) levels, decreased platelet count, elevated B-type natriuretic peptide (BNP), and decreased oxygen partial pressure (PaO2). These findings suggest that close monitoring of these markers is essential in clinical practice to identify patients at high risk of adverse events early on.

CONCLUSION

Our study provides evidence that serum creatinine, BUN, platelet count, BNP, and PaO2 are independent predictors of adverse outcomes in patients with Type 2 CRS.

摘要

背景

2型心肾综合征的特征是继发于慢性心脏疾病的肾功能障碍。尽管其发病率和死亡率很高,但缺乏强有力的诊断工具和预后模型来指导临床管理。

方法

这项多中心回顾性研究纳入了根据2019年美国心脏协会定义诊断为2型心肾综合征的患者。数据收集自2021年1月至2023年12月期间三家医院的电子病历。采用包括受试者工作特征(ROC)曲线分析、单变量Kaplan-Meier(KM)分析和多变量Cox比例风险回归在内的先进统计方法,开发了一个预测患者预后的列线图。

结果

该研究纳入了519例2型心肾综合征患者。不良结局的独立预测因素包括血清肌酐和血尿素氮(BUN)水平升高、血小板计数降低、B型利钠肽(BNP)升高和氧分压(PaO2)降低。这些发现表明,在临床实践中密切监测这些指标对于早期识别不良事件高危患者至关重要。

结论

我们的研究提供了证据,表明血清肌酐、BUN、血小板计数、BNP和PaO2是2型心肾综合征患者不良结局的独立预测因素。

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本文引用的文献

1
Exploring diagnostic biomarkers of type 2 cardio-renal syndrome based on secreted proteins and bioinformatics analysis.基于分泌蛋白和生物信息学分析探讨 2 型心肾综合征的诊断生物标志物。
Sci Rep. 2024 Oct 19;14(1):24612. doi: 10.1038/s41598-024-75580-1.
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Increased cardiovascular risk in patients with chronic kidney disease.慢性肾脏病患者心血管风险增加。
Herz. 2024 Mar;49(2):95-104. doi: 10.1007/s00059-024-05235-4. Epub 2024 Feb 28.
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Effects of hypoxia in cardiac metabolic remodeling and heart failure.缺氧对心脏代谢重构和心力衰竭的影响。
Exp Cell Res. 2023 Nov 1;432(1):113763. doi: 10.1016/j.yexcr.2023.113763. Epub 2023 Sep 17.
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Cardiorenal Syndrome: A Literature Review.心肾综合征:文献综述
Cureus. 2023 Jul 1;15(7):e41252. doi: 10.7759/cureus.41252. eCollection 2023 Jul.
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A comprehensive review of acute cardio-renal syndrome: need for novel biomarkers.急性心肾综合征的全面综述:对新型生物标志物的需求
Front Pharmacol. 2023 May 23;14:1152055. doi: 10.3389/fphar.2023.1152055. eCollection 2023.
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New Insight in Cardiorenal Syndrome: From Biomarkers to Therapy.心肾综合征的新认识:从生物标志物到治疗。
Int J Mol Sci. 2023 Mar 7;24(6):5089. doi: 10.3390/ijms24065089.
7
Heart Failure and Cardiorenal Syndrome: A Narrative Review on Pathophysiology, Diagnostic and Therapeutic Regimens-From a Cardiologist's View.心力衰竭与心肾综合征:从心脏病学家视角对病理生理学、诊断及治疗方案的叙述性综述
J Clin Med. 2022 Nov 28;11(23):7041. doi: 10.3390/jcm11237041.
8
Biomarkers in Cardiorenal Syndrome and Potential Insights Into Novel Therapeutics.心肾综合征中的生物标志物及对新型治疗方法的潜在见解
Front Cardiovasc Med. 2022 May 20;9:868658. doi: 10.3389/fcvm.2022.868658. eCollection 2022.
9
Association of SGLT2 inhibitors with cardiovascular, kidney, and safety outcomes among patients with diabetic kidney disease: a meta-analysis.SGLT2 抑制剂在糖尿病肾病患者中的心血管、肾脏和安全性结局的相关性:一项荟萃分析。
Cardiovasc Diabetol. 2022 Mar 23;21(1):47. doi: 10.1186/s12933-022-01476-x.
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Hypoxia and chronic kidney disease.缺氧与慢性肾脏病。
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