检索规则说明:AND代表“并且”;OR代表“或者”;NOT代表“不包含”;(注意必须大写,运算符两边需空一格)
检 索 范 例 :范例一: (K=图书馆学 OR K=情报学) AND A=范并思 范例二:J=计算机应用与软件 AND (U=C++ OR U=Basic) NOT M=Visual
作 者:李梦霞[1] 严洁[2] 王震[1] 李晓忠[1] 冯星[2] 李艳红[1]
机构地区:[1]苏州大学附属儿童医院肾脏科, 215003 [2]苏州大学附属儿童医院新生儿科, 215003
出 处:《中华实用儿科临床杂志》2014年第18期1385-1388,共4页Chinese Journal of Applied Clinical Pediatrics
基 金:国家自然科学基金(81370773);江苏省自然科学基金(BK2012604);江苏省教育厅面上项目(12KJB320006)
摘 要:目的 探讨尿胱抑素C(uCys C)对危重新生儿病死率的早期预测价值.方法 选择2011年5月至2012年10月在出生6h内入住苏州大学附属儿童医院新生儿重症监护病房的新生儿为研究对象,进行前瞻性研究.根据自入院在1周内是否死亡分为死亡组和生存组(对照组).检测患儿入院当日uCys C水平,并于入院24 h内进行新生儿急性生理学评分(SNAP).多因素Logistic回归分析评估在校正混杂因素后uCys C与死亡的关系,用受试者工作特征曲线及曲线下面积(AUC)评估uCys C对死亡的预测价值.结果 研究期间共纳入155例新生儿,12例(7.1%)新生儿在入院1周内死亡.死亡组胎龄(t =2.810,P=0.006)、出生体质量(t=3.245,P=0.001)均显著低于对照组,uCys C(2=-3.426,P=0.001)、SNAP评分(z=-3.308,P=0.001)、机械通气(x2=23.877,P=0.000)的使用率均显著高与对照组.Logistic回归分析显示,在校正胎龄、出生体质量等因素后,uCys C水平仍与死亡显著相关.uCys C水平预测新生儿死亡的AUC值为0.81(95% CI:0.71 ~0.92,P=0.001);联合SNAP和机械通气后,其预测死亡的AUC为0.93(95% CI:0.86 ~1.00,P=0.000).结论 uCys C是新生儿死亡的独立预测指标,将其与SNAP、机械通气联合后有更好的预测价值.Objective To determine if urinary cystatin C (uCys C) level can predict mortality in critically ill neonates.Methods This prospective study included neonates admitted to the intensive care unit within the first 6 hours of life from May.2011 to Oct.2012.Neonates were assigned into survivor and non-survivor groups based on whether they died during the first week of life.The uCys C level was measured on the day of admission.The score for neonatal acute physiology (SNAP) was calculated based on 28 items collected during the first 24 hours of admission.Multivariate Logistic regression analysis was used to determine whether uCys C level was a predictor of mortality.A receiver operating characteristic (ROC) curve was constructed and the area under the ROC curve (AUC) was calculated to assess the predictive strength.Results Of the total 155 neonates,12 cases (7.1%) died during the first week of life.When compared to survivors,the gestational age (t =2.810,P =0.006) and birth weight (t =3.245,P =0.001) in non-survivors were significantly lower; but the uCys C level (z =-3.426,P =0.001),the SNAP score (z =-3.308,P =0.001),and the use of mechanical ventilation (x2 =23.877,P =0.000) were significantly higher.Logistic regression analysis revealed that uCys C remained significantly associated with mortality after adjusting for gestation age,birth weight,or the SNAP score (P =0.024).uCys C achieved AUC of 0.81 (95% CI:0.71-0.92,P =0.001).When combined with SNAP and mechanical ventilation,the predictive performance of uCys C improved AUC 0.93 (95 % CI:0.86-1.00,P =0.000).Conclusion uCys C is significantly associated with adverse outcome of death and independently predictive of mortality in critically ill neonates.
正在载入数据...
正在载入数据...
正在载入数据...
正在载入数据...
正在载入数据...
正在载入数据...
正在载入数据...
正在链接到云南高校图书馆文献保障联盟下载...
云南高校图书馆联盟文献共享服务平台 版权所有©
您的IP:216.73.216.179