摘要
目的探讨超敏C反应蛋白(hs-CRP)、D-二聚体(D-D)、降钙素原(PCT)对Standford B型主动脉夹层(TBAD)患者胸主动脉腔内修复术预后的影响。方法选取2017年4月至2022年3月抚州市第一人民医院行胸主动脉腔内修复术(TEVAR)的80例TBAD患者作为研究对象,于术前1 d和术后7 d检测hs-CRP、D-D、PCT水平。根据患者预后分为预后良好组和预后不良组,比较两组患者术前1 d和术后7 d的血清hs-CRP、D-D、PCT水平,分析血清hs-CRP、D-D、PCT水平与患者预后的关联性。结果80例患者中预后良好(预后良好组)63例(78.75%),预后不良(预后不良组)17例(21.25%)。两组患者术后7 d血清hs-CRP、D-D、PCT水平高于本组术前1 d,差异有统计学意义(P<0.05);预后良好组患者术前1 d和术后7 d的血清hs-CRP、D-D、PCT水平低于预后不良组,差异有统计学意义(P<0.05);logistic回归模型分析结果显示,术前1 d血清hs-CRP(β=0.617,OR=1.854,95%CI=1.217~2.696)、D-D(β=0.639,OR=1.895,95%CI=1.841~2.635)、PCT(β=0.554,OR=1.741,95%CI=1.547~3.052)和术后7 d hs-CRP(β=0.892,OR=2.440,95%CI=1.251~4.761)、D-D(β=0.797,OR=2.219,95%CI=1.669~3.141)、PCT(β=0.604,OR=1.829,95%CI=1.058~2.969)水平是接受TEVAR治疗的TBAD患者预后的影响因素,差异有统计学意义(P<0.05)。结论监测围手术期血清hs-CRP、D-D、PCT水平对接受TEVAR治疗的TBAD患者预后判断具有一定的参考价值。
Objective To investigate the effects of hypersensitive C-reactive protein(hs-CRP),D-dimer(D-D)and procalcitonin(PCT)on the prognosis of thoracic aortic endovascular repair in Standford Type B aortic dissection(TBAD).Methods A total of 80 TBAD patients who underwent thoracic aortic endovascular repair(TEVAR)in the First People's Hospital of Fuzhou from April 2017 to March 2022 were selected as the study objects.Serum levels of High sensitivity C-reactive protein(hs-CRP),D-dimer(D-D)and procalcitonin(PCT)were detected 1 day before surgery and 7 days after surgery.Patients were divided into good prognosis group and poor prognosis group according to the prognosis.Serum hs-CRP,D-D and PCT levels of the two groups were compared 1 day before surgery and 7 days after surgery,and the correlation between serum hs-CRP,D-D and PCT levels and the prognosis of the patients was analyzed.Results Of the 80 patients,63 cases(78.75%)had good prognosis(good prognosis group)and 17 cases(21.25%)had poor prognosis(poor prognosis group).Serum hs-CRP,D-D and PCT levels in 2 groups were significantly higher on day 7 after surgery than on day 1 before surgery(P<0.05).Serum hs-CRP,D-D and PCT levels in the good prognosis group were lower than those in the poor prognosis group 1 day before and 7 days after surgery,with statistical significances(P<0.05).The results of logistic regression model analysis showed that serum preoperative 1 day hs-CRP(β=0.617,OR=1.854,95%CI=1.217-2.696),D-D(β=0.639,OR=1.895,95%CI=1.841-2.635),and PCT(β=0.554,OR=1.741,95%CI=1.547-3.052)levels and postoperative 7 days hs-CRP(β=0.892,OR=2.440,95%CI=1.251-4.761),D-D(β=0.797,OR=2.219,95%CI=1.669-3.141),and PCT(β=0.604,OR=1.829,95%CI=1.058-2.969)levels were the influencing factors of the prognosis of TBAD patients treated with TEVAR.Conclusion Monitoring the levels of serum hs-CRP,D-D and PCT in perioperative period is valuable for prognostic judgment of TBAD patients treated with TEVAR.
作者
吴跃武
胡斌
付琴
过小冬
WU Yuewu;HU Bin;FU Qin;GUO Xiaodong(Department of Cardiothoracic Surgery,the First People's Hospital of Fuzhou,Jiangxi Province,Fuzhou344000,China)
出处
《中国当代医药》
CAS
2024年第10期62-65,70,共5页
China Modern Medicine
基金
江西省卫生健康委科技计划项目(202212875)。
