两种血清指标联合检测对非心脏手术围术期心脏不良事件发生的预测价值分析  

Value of two serum indexes detected in combination for predicting perioperative adverse cardiac events after non-cardiac surgery

作　　者：张鑫[1] 王慧[1] 刘肃[1] 李伟[1] 张春玲[1] 张鹏祥[1] 李方江[1] Zhang Xin;Wang Hui;Liu Su;Li Wei;Zhang Chunling;Zhang Pengxiang;Li Fangjiang(Department of Orthopedics,First Affiliated Hospital of Hebei North College,Zhangjiakou 075061,Hebei Province,China)

机构地区：[1]河北北方学院附属第一医院骨外科,张家口市075061

出　　处：《中华老年心脑血管病杂志》2021年第11期1177-1179,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：张家口市重点研发计划项目(2021107D)。

摘　　要：目的探讨血清可溶性肿瘤坏死因子样凋亡弱诱导因子(sTWEAK)、髓过氧化物酶(MPO)水平对非心脏手术患者围术期心脏不良事件发生的预测价值。方法选取老年非心脏手术患者200例,根据围术期是否发生心脏不良事件分为观察组75例和对照组125例。对比2组血清sTWEAK、MPO水平。结果观察组年龄、高血压、糖尿病、高脂血症、麻醉时间>2 h比例、血清sTWEAK、MPO水平明显高于对照组(P<0.05,P<0.01)。高血压、糖尿病、麻醉时间>2 h、sTWEAK、MPO为非心脏手术患者围术期心脏不良事件发生的独立危险因素(P<0.05,P<0.01)。sTWEAK+MPO预测围术期心脏不良事件发生的ROC曲线下面积为0.875(95%CI:0.821~0.917),明显高于sTWEAK、MPO预测(P<0.01)。结论非心脏手术围术期发生心脏不良事件患者术前血清sTWEAK、MPO水平明显提升,为心脏不良事件潜在独立危险因素,联合检测可提升心脏不良事件预测价值。Objective To study the value of serum sTWEAK and MPO levels measured in combination for predicting perioperative ACE after non-cardiac surgery.Methods Two hundred elderly patients without cardiac surgery were divided into observation group(n=75)and control group(n=125)according to their perioperative ACE after non-cardiac surgery.The serum sTWEAK and MPO levels in two groups were measured.Results The age was significantly older,and the incidence of hypertension,DM,hyperlipidemia,ratio of anesthesia time>2 h,serum levels of sTWEAK and MPO were significantly higher in observation group than in control group(P<0.05,P<0.01).Multivariate logistic regression analysis showed that hypertension,DM,anesthesia time>2 h,sTWEAK and MPO were independent risk factors for perioperative ACE after non-cardiac surgery(P<0.05,P<0.01).ROC curve analysis displayed that the AUC of sTWEAK+MPO for predicting perioperative ACE after non-cardiac surgery was 0.875(95%CI:0.821-0.917),which was significantly higher than that of sTWEAK or MPO for predicting perioperative ACE after non-cardiac surgery(P<0.01).Conclusion Elevated serum sTWEAK and MPO levels before periopertive ACE are independent risk factor for perioperative ACE after non-cardic surgery.Combined measurement can improve their value for predicting perioperative ACE after non-cardic surgery.

关 键 词：肿瘤坏死因子类 过氧化物酶 围手术期 高血压 

分 类 号：R619[医药卫生—外科学]