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作 者:曹克军 刘佩本 左祥荣 CAO Kejun;LIU Peiben;ZUO Xiangrong(Department of Critical Care Medicine,The First Affiliated Hospital of Nanjing Medical University,Jiangsu 210029,China)
机构地区:[1]南京医科大学第一附属医院重症医学科,210029
出 处:《医学研究杂志》2023年第3期81-86,共6页Journal of Medical Research
基 金:江苏省第五期“333高层次人才培养工程”第三层次人才项目{苏人才办[2018]26号};江苏省高层次卫生人才“六个一工程”拔尖人才科研项目(LGY2019067)。
摘 要:目的系统评价二维斑点追踪超声心动图(speckle tracking echocardiography,STE)检查左心室整体纵向应变(left ventricular global longitudinal strain,LVGLS)对脓毒症及脓毒性休克患者预后的预测价值。方法计算机检索PubMed、EMbase、Web of Science、Cochrane Library、CNKI、万方数据库、维普数据库和中国生物医学文献数据库(CBM),时间从建库至2021年11月5日,收集所有报告LVGLS,无论有无左心室射血分数(left ventricular ejection fraction,LVEF)的脓毒症及脓毒性休克患者短期病死率的研究。由2名研究员参照纳入与排除标准独立使用NoteExpress软件筛选文献,提取文献信息及质量评价后,使用RevMan 5.4及Stata 16.0软件进行统计分析。结果最终纳入11项前瞻性观察性研究,共1075例患者。Meta分析结果显示,生存组较死亡组在脓毒症及脓毒性休克患者中有更负的LVGLS,差异有统计学意义(SMD=-0.43,95%CI:-0.63~-0.24,P<0.001),而LVEF在两组中比较,差异无统计学意义(SMD=0.09,95%CI:-0.04~0.23,P=0.18)。结论STE测量的LVGLS作为左心室收缩功能指标,可以预测脓毒症及脓毒性休克患者的短期预后,有助于临床早期识别高危患者。Objective To systematically evaluate the prognostic value of left ventricular global longitudinal strain(LVGLS)by two-dimensional speckle tracking echocardiography(STE)in patients with sepsis and septic shock.Methods PubMed,Embase,Web of Science,Cochrane Library,CNKI,WanFang Data,VIP and CBM databases were electronically searched to collect studies on LVGLS and short-term mortality in patients with sepsis and septic shock from inception to November 5th,2021,with or excluding left ventricular ejection fraction(LVEF).Two reviewers independently used NoteExpress software to screen literature according to the inclusion criteria and exclusion criteria,extracting data and assessing the risk of bias of included studies.RevMan 5.4 and Stata 16.0software then were used for Meta-analysis.Results A total of 11 prospective studies involving 1075 patients were analyzed.The results of Meta-analysis showed that the survival group had a more negative LVGLS in patients with sepsis and septic shock than the death group,and the difference was statistically significant(SMD=-0.43,95%CI:-0.63--0.24,P<0.001),whereas LVEF was no statistically significant difference between the two groups(SMD=0.09,95%CI:-0.04-0.23,P=0.18).Conclusion The LVGLS measured by STE is correlated with short-term mortality in patients with sepsis and septic shock,as an indicator of left ventricular systolic function,which helps to identify high-risk patients early.
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