乳酸脱氢酶与急性主动脉夹层院内死亡关系研究  

Lactate dehydrogenase as a predictor of in-hospital mortality in patients with acute aortic dissection

作　　者：李长罗[1] 龙勇[1] 袁锋[1] 杨贵芳[2] 盛丽娟[3] LI Changluo;LONG Yong;YUAN Feng;YANG Guifang;SHENG Lijuan(Department of Emergency Medicine,Changsha Central Hospital,Changsha,410000,P.R.China;Department of Emergency Medicine,The Second Xiangya Hospital,Central South University,Changsha,410011,P.R.China;Department of Neurology,The Second Xiangya Hospital,Central South University,Changsha,410011,P.R.China)

机构地区：[1]长沙市中心医院急诊科,长沙410000 [2]中南大学湘雅二医院急诊科,长沙410011 [3]中南大学湘雅二医院神经内科,长沙410011

出　　处：《中国胸心血管外科临床杂志》2019年第12期1213-1218,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的探讨乳酸脱氢酶(lactate dehydrogenase,LDH)对急性主动脉夹层(acute aortic dissection,AAD)患者院内死亡的预测意义。方法回顾性分析2016年1月至2017年12月在中南大学湘雅二医院及长沙市中心医院445例AAD患者的临床资料,其中男353例、女92例,年龄45~61岁,发病时间间隔为从症状出现到入院14 d内。院内死亡定义为在住院期间的全因死亡。入院时完善了LDH的测定,研究终点为住院期间的全因死亡。结果住院期间死亡86例,存活359例。死亡组的LDH水平高于存活组[269.50(220.57,362.58)U/L vs.238.00(191.25,289.15)U/L,P<0.001]。平滑曲线拟合显示,LDH与AAD患者院内死亡呈非线性关系。多因素logistic回归分析显示,LDH是AAD院内死亡的独立预测因子[OR=1.002,95%CI(1.001,1.004),P=0.006]。经受试者工作特征(receiver operating characteristic,ROC)曲线分析,其最佳阈值为280.70 U/L,曲线下面积为0.624(95%CI 0.556,0.689)。结论入院时LDH是AAD患者院内死亡的独立预测因子。Objective To evaluate the significance of lactate dehydrogenase(LDH)as a predictor of in-hospital mortality in patients with acute aortic dissection(AAD).Methods We conducted a retrospective analysis of the clinical data of 445 AAD patients who were admitted to the Second Xiangya Hospital of Central South University and the Changsha Central Hospital from January 2014 to December 2017 within a time interval of≤14 days from the onset of symptoms to hospital admission,including 353 males and 92 females with the age of 45-61 years.LDH levels were measured on admission and the endpoint was the all-cause mortality during hospitalization.Results During hospitalization,86 patients died and 359 patients survived.Increased level of LDH was found in non-survivors compared with that in the survived[269.50(220.57,362.58)U/L vs.238.00(191.25,289.15)U/L,P<0.001].A nonlinear relationship between LDH levels and in-hospital mortality was observed.Using multivariable logistic analysis,we found that LDH was an independent predictor of in-hospital mortality in the patients with AAD[OR=1.002,95%CI(1.001 to 1.014),P=0.006].Furthermore,using receiver operating characteristic(ROC)analysis,we observed that the best threshold of LDH level was280.70 U/L,and the area under the curve was 0.624(95%CI 0.556 to 0.689).Conclusion LDH level on admission is an independent predictor of in-hospital mortality in patients with AAD.

关 键 词：乳酸脱氢酶 急性主动脉夹层 院内死亡 

分 类 号：R54[医药卫生—心血管疾病]