摘要
目的分析血清血管性血友病因子特异性裂解酶(a disintegrin-like and metalloprotease with thrombospondin type1 motif,member 13,ADAMTS13)水平与接受体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)治疗患者的预后关系。方法本研究选取2020年1月—2022年6月在湖南医药学院第一附属医院接受ECMO治疗的42例患者,按照ECMO撤离1个月内预后分为生存组(n=29)和死亡组(n=13)。通过分析接受ECMO治疗患者的血清ADAMTS13水平,分析血清ADAMTS13与接受ECMO治疗患者的预后。结果生存组年龄小于死亡组(P<0.001)。2组性别和体表面积比较,差异无统计学意义(P>0.05)。生存组平均动脉压为(54.24±5.81)mmHg、氧合指数为(178.84±29.38)mmHg,均高于死亡组的(52.56±4.42)mmHg、(155.71±23.12)mmHg;生存组急性生理与慢性健康评分(acute physiology and chronic health evaluation-Ⅱ,APACHE-Ⅱ)评分为(22.51±2.62)分,低于生存组的(27.35±3.85)分(P<0.05)。2组左室射血分数和ECMO流量比较,差异无统计学意义(P>0.05)。ECMO治疗后,2组血清ADAMTS13水平升高。生存组ECMO治疗前1 h及治疗后24 h、48 h血清ADAMTS13水平高于死亡组,差异有统计学意义(P<0.001)。ECMO治疗48 h后血清ADAMTS13水平为ECMO辅助治疗患者死亡的独立危险因素(P<0.001)。结论接受ECMO治疗患者的血清ADAMTS13水平降低与预后不佳相关。
Objective To analyze the relationship between serum a disintegrin-like and metalloprotease with thrombospondin type 1 motif,member 13(ADAMTS13) level and prognosis of patients receiving extracorporeal membrane oxygenation(ECMO).Methods A total of 42 patients who received ECMO in the First Affiliated Hospital of Hu'nan University of Medicine from January 2020 to June 2022 were divided into survival group(n =29) and death group(n =13) according to the prognosis of patients within 1 month after ECMO withdrawal.By analyzing serum ADAMTS13levels in patients treated with ECMO,the prognosis of serum ADAMTS13 and patients treated with ECMO was analyzed.Results The age of survival group was lower than that of death group(P <0.001).There was no significant difference in gender and body surface area between the two groups(P > 0.05).The mean arterial pressure and oxygenation index of survival group were(54.24±5.81) mmHg and(178.84±29.38)mm Hg,which were higher than those of death group of(52.56±4.42) mmHg and(155.71±23.12)mmHg.Acute physiology and chronic health evaluation-Ⅱ(APACHE-Ⅱ) score of survival group was(22.51±2.62) points,lower than that of death group of(27.35±3.85)points(P < 0.05).There was no significant difference in left ventricular ejection fraction and ECMO flow between the two groups(P > 0.05).After ECMO treatment,the level of serum ADAMTS13 increased in both groups.The serum ADAMTS13 levels in the survival group were higher than that in the death group 1 h before ECMO treatment and 24 h and 48 h after ECMO treatment,and the differences were statistically significant(P < 0.001).The serum ADAMTS13 levels after 48 h of ECMO treatment were an independent risk factor for death in patients treated with ECMO adjuvant therapy(P < 0.001).Conclusion Decreased serum ADAMTS13 levels in patients receiving ECMO are associated with poor prognosis.
作者
陈华桂
肖杰
万剑波
丁冬梅
马兰
CHEN Huagui;XIAO Jie;WAN Jianbo;DING Dongmei;MA Lan(Department of Clinical Laboratory,the First Affiliated Hospital of Hu'nan University of Medicine,Huaihua Hu'nan 418000,China;Department of Clinical Laboratory,Aier Eye Hospital Group Co.,Ltd,Changsha Hu'nan 410125,China;Department of Clinical Laboratory,Wuhan University Affiliated Aier Eye Hospital,Wuhan Hubei 430064,China;Department of Clinical Laboratory,Changsha Aier Eye Hospital,Changsha Hu'nan 410015,China;Department of Clinical Laboratory,Nanning Aier Eye Hospital,Nanning Guangxi 530004,China;Department of Clinical Laboratory,Harbin Aier Eye Hospital,Harbin Heilongjiang 150000,China)
出处
《中国卫生标准管理》
2024年第4期110-113,共4页
China Health Standard Management
基金
湖南省卫生健康委科研计划项目(20200073)。
