摘要
目的探讨急性A型主动脉夹层患者入院24 h内脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)水平与住院预后的关系。方法纳入南京医院2017年1月至2019年6月确诊为A型主动脉夹层行手术治疗患者46例。测定入院24 h内Lp-PLA2水平,将23例患者纳入高Lp-PLA2组[LpPLA2>200μg/L,男16例、女7例,年龄(52.0±14.0)岁],23例患者纳入低Lp-PLA2组[Lp-PLA2≤200μg/L,男15例、女8例,年龄(53.0±11.0)岁]。分析Lp-PLA2水平与临床结局之间的关系。结果高Lp-PLA2组大出血发生率、医院感染发生率、多器官功能障碍发生率、死亡率均高于低Lp-PLA2组(P<0.05)。随访3个月,死亡7例(15.2%),Lp-PLA2明显升高患者3个月生存率明显低于Lp-PLA2水平正常的患者(P<0.01),Lp-PLA2是发病3个月不良结局的独立预测因子(P<0.01)。结论 Lp-PLA2可能是急性A型主动脉夹层患者病情进展的一种预测因子,Lp-PLA2明显升高患者与Lp-PLA2正常患者相比3个月死亡率有更高。
Objective To investigate the relationship between lipoprotein-associated phospholipase A2(LpPLA2) level and in-hospital prognosis in patients with acute type A aortic dissection within 24 hours of admission.Methods Fortysix patients diagnosed with type A aortic dissection were included in our hospital and their Lp-PLA2 levels within 24 hours of admission were measured between January 2017 and June 2019.According to their Lp-PLA2 levels within 24 hours of admission,23 patients were classified into a high Lp-PLA2 group(Lp-PLA2> 200 μg/L,16 males and 7 females at age of 52.0±14.0 years) and 23 patients were into a low Lp-PLA2 group(Lp-PLA2 ≤200 μg/L,15 males and 8 females at age of 53.0±11.0 years).The relationship between Lp-PLA2 level and clinical outcome was analyzed.Results The incidences of bleeding,hospital infection,multiple organ dysfunction and mortality in the high Lp-PLA2 group were higher than those in the low Lp-PLA2 group(P<0.05).Seven(15.2%) patients died during 3 months of followup.The 3-month survival rate of patients with an increase of Lp-PLA2 was significantly lower than that of the patients with normal Lp-PLA2(P<0.01),which was an independent predictor of adverse outcomes at 3 months of onset(P<0.01).Conclusion Lp-PLA2 maybe a predictor of disease progression in the patients with acute type A aortic dissection,and the patients with significantly elevated Lp-PLA2 have a higher 3-month mortality than the patients with normal Lp-PLA2.
作者
牛永胜
聂帅
黄福华
穆心苇
章淬
NIU Yongsheng;NIE Shuai;HUANG Fuhua;MU Xinwei;ZHANG Cui(Department of Critical Care Medicine,Nanjing First Hospital,Nanjing Medical University,Nanjing,210006,P.R.China;Department of Thoracic and Cardiovascular Surgery,Nanjing First Hospital,Nanjing Medical University,Nanjing,210006,P.R.China)
出处
《中国胸心血管外科临床杂志》
CAS
CSCD
2020年第9期1031-1036,共6页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
江苏省临床医学科技专项(BE2017610)。
关键词
主动脉夹层
脂蛋白相关磷脂酶A2
炎症反应
预后
Aortic dissection
lipoprotein-associated phospholipase A2
inflammatory response
prognosis
