肠脂肪酸结合蛋白与心源性休克患者的预后相关性分析  

作　　者：张伟[1] 俞振飞 张美齐 

机构地区：[1]浙江中医药大学附属杭州市中医院,310000

出　　处：《浙江临床医学》2024年第6期886-888,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划项目(2020KY749)。

摘　　要：目的探讨血清肠脂肪酸结合蛋白(IFABP)对重症医学科(ICU)心源性休克患者预后的预测。方法选择2020年1月至2022年5月ICU心源性休克患者99例。入ICU24h、3d采用酶联免疫吸附试验(ELISA)测定血清IFABP浓度,根据28d生存情况分为存活组和死亡组,比较两组患者IFABP浓度变化及对生存预后的影响。结果心源性休克患者28 d存活62例,存活率62.6%,存活组患者APAECH II评分及SOFA评分低于死亡组、呼吸机使用和血管活性药物比例低于死亡组,差异有统计学意义(P<0.05)。存活组入ICU 24 h、3 d血清IFABP浓度均低于死亡组(P<0.05)。Logistic回归分析显示,入ICU24 h血清IFABP水平、APACHE II评分及SOFA评分为影响心源性休克患者28 d死亡的危险因素(P<0.05)。ROC曲线分析IFABP对心源性休克患者预后有更好的预测价值,敏感性83.8%、特异性61.3%。结论IFABP血清水平对心源性休克患者28d生存有预测价值,血清IFABP浓度升高与心源性休克患者存活率下降有关。Objective To investigate whether circulating levels of intestinal fatty-acid-binding proteins(IFABP)are associated with mortality in patients with cardiogenic shock in intensive care unit(ICU)admission.Methods 99 patients with cardiogenic shock in the ICU from January 2020 to May 2022 were selected.Serum levels of IFABP was measured within 24 hours after admission and at day 3.The patients were divided into a survival group(62 cases)and a death group(37 cases)according to the survival situation on the 28th day.The difference of IFABP concentration between the two groups and its effect on survival prognosis were analyzed.Results 62 patients with cardiogenic shock survived in 28 d,and the survival rate was 62.6%.The APAECH II score and SOFA score of the survival group were significantly lower than those of the death group,and the proportion of ventilator use and vasoactive drugs was lower than that of the death group,with significant statistical significance.The serum IFABP concentration in the survival group was lower than that in the death group at 24 hours and 3 days after ICU admission,and there was a significant correlation at each time point(P<0.05).Logistic regression analysis showed that Serum levels of IFABP within 24 hours,APACHE II score and SOFA score were risk factors for 28d mortality in patients with cardiogenic shock(P<0.05).IFABP showed a higher prognostic value for patients with cardiogenic shock,with sensitivity and specificity of 83.8%and 61.3%.Conclusion Circulating levels of IFABP provide evidence for predicting 28-day survival in patients with cardiogenic shock in intensive care unit.The increased levels of IFABP concentration may be associated with a dramatically decreased survival in patients with cardiogenic shock.

关 键 词：肠脂肪酸结合蛋白 心源性休克 肠灌注 心输出量 重症医学科 

分 类 号：R541.64[医药卫生—心血管疾病]