Objective:To investigate the contribution of N-terminal pro B-type natriuretic peptide(NT-pro BNP)and troponin Ⅰ to mortality in children with dengue shock syndrome.Methods:A longitudinal study was conducted on child...Objective:To investigate the contribution of N-terminal pro B-type natriuretic peptide(NT-pro BNP)and troponin Ⅰ to mortality in children with dengue shock syndrome.Methods:A longitudinal study was conducted on children with dengue shock syndrome in a hospital in southern Vietnam.Detailed clinical histories,physical examinations,and laboratory parameters,including NT-pro BNP and troponin Ⅰ,were recorded.A comparison between survival and non-survival was carried out to identify factors influencing mortality.Results:A total of 107 patients with a median age of 9 years were included in the study.Among them,63.6%(68/107)presented with compensated shock,36.4%(39/107)had hypotensive shock,23.4%(25/107)required mechanical ventilation,and 12.1%(13/107)died.The NT-pro BNP levels were 3.9 pmol/L(IQR:1.9,10.3)and 15.2 pmol/L(5.8,46.3),while the median high sensitivity troponin Ⅰ levels were 20 pg/L(6,95)and 62 pg/L(12,325)at the first and second measurements,respectively.The mortality group exhibited higher rates of hypotensive shock,prolonged shock,lactate levels,liver damage,NT-pro BNP,and troponin Ⅰ levels.Hypotensive shock(OR 12.96,95%CI 2.70-62.30,P=0.004),prolonged shock(OR 39.40,95%CI 6.68-232.70,P<0.001),AST>1000 IU/L(OR 9.50,95%CI 2.63-34.34,P=0.041),and NT-pro BNP>7 pmol/L(OR 44.40,95%CI 5.44-362.20,P=0.001)were identified as predictive factors for mortality in dengue shock syndrome.Conclusions:The NT-pro BNP level could serve as a potential biomarker for predicting mortality in children with dengue shock syndrome.展开更多
目的探讨心外科ICU患者术后感染血清降钙素原(PCT)、P-选择素糖蛋白配体1(PSGL-1)、可溶性细胞间粘附因子-1(sICAM-1)与心肌肌钙蛋白I(cTnⅠ)的变化及意义。方法选取本院2016年1月至2019年3月心外科ICU患者108例,根据术后是否发生感染...目的探讨心外科ICU患者术后感染血清降钙素原(PCT)、P-选择素糖蛋白配体1(PSGL-1)、可溶性细胞间粘附因子-1(sICAM-1)与心肌肌钙蛋白I(cTnⅠ)的变化及意义。方法选取本院2016年1月至2019年3月心外科ICU患者108例,根据术后是否发生感染分为感染组37例、未感染组71例,另选择同期健康体检者48例作为对照组。比较3组血清PCT、PSGL-1、sICAM-1、cTnⅠ水平,Logistic回归分析心外科ICU患者术后感染的影响因素,Pearson相关性分析血清PCT、PSGL-1、sICAM-1与cTnⅠ关联性,对比感染组不同预后患者血清PCT、PSGL-1、sICAM-1、cTnⅠ水平,受试者工作特征(ROC)曲线分析各血清因子对预后的预测价值,采用Kaplan-Meier曲线进行生存分析。结果感染组血清PCT、PSGL-1、sICAM-1、cTnⅠ水平高于未感染组、对照组差异有统计学意义(P<0.05);合并基础性疾病、血清PCT、PSGL-1、sICAM-1、cTnⅠ是心外科ICU患者发生术后感染的独立危险因素(P<0.05);血清PCT、PSGL-1、sICAM-1与cTnⅠ呈正相关(P<0.05);感染第3、5天生存者血清PCT、PSGL-1、sICAM-1、cTnⅠ水平低于死亡者(P<0.05);感染第5 d cTnⅠ预测心外科ICU患者术后感染预后的AUC值最大,为0.804;随访28 d,血清PCT、PSGL-1、sICAM-1、cTnⅠ低危组、高危组的生存曲线对比,差异有统计学意义(P<0.05)。结论心外科ICU患者术后感染会引起血清PCT、PSGL-1、sICAM-1、c TnI异常表达,且表达水平与感染发生发展及预后有一定相关性,临床可通过监测上述血清因子表达超早期予以干预治疗,以改善预后。展开更多
文摘Objective:To investigate the contribution of N-terminal pro B-type natriuretic peptide(NT-pro BNP)and troponin Ⅰ to mortality in children with dengue shock syndrome.Methods:A longitudinal study was conducted on children with dengue shock syndrome in a hospital in southern Vietnam.Detailed clinical histories,physical examinations,and laboratory parameters,including NT-pro BNP and troponin Ⅰ,were recorded.A comparison between survival and non-survival was carried out to identify factors influencing mortality.Results:A total of 107 patients with a median age of 9 years were included in the study.Among them,63.6%(68/107)presented with compensated shock,36.4%(39/107)had hypotensive shock,23.4%(25/107)required mechanical ventilation,and 12.1%(13/107)died.The NT-pro BNP levels were 3.9 pmol/L(IQR:1.9,10.3)and 15.2 pmol/L(5.8,46.3),while the median high sensitivity troponin Ⅰ levels were 20 pg/L(6,95)and 62 pg/L(12,325)at the first and second measurements,respectively.The mortality group exhibited higher rates of hypotensive shock,prolonged shock,lactate levels,liver damage,NT-pro BNP,and troponin Ⅰ levels.Hypotensive shock(OR 12.96,95%CI 2.70-62.30,P=0.004),prolonged shock(OR 39.40,95%CI 6.68-232.70,P<0.001),AST>1000 IU/L(OR 9.50,95%CI 2.63-34.34,P=0.041),and NT-pro BNP>7 pmol/L(OR 44.40,95%CI 5.44-362.20,P=0.001)were identified as predictive factors for mortality in dengue shock syndrome.Conclusions:The NT-pro BNP level could serve as a potential biomarker for predicting mortality in children with dengue shock syndrome.
文摘目的探讨心外科ICU患者术后感染血清降钙素原(PCT)、P-选择素糖蛋白配体1(PSGL-1)、可溶性细胞间粘附因子-1(sICAM-1)与心肌肌钙蛋白I(cTnⅠ)的变化及意义。方法选取本院2016年1月至2019年3月心外科ICU患者108例,根据术后是否发生感染分为感染组37例、未感染组71例,另选择同期健康体检者48例作为对照组。比较3组血清PCT、PSGL-1、sICAM-1、cTnⅠ水平,Logistic回归分析心外科ICU患者术后感染的影响因素,Pearson相关性分析血清PCT、PSGL-1、sICAM-1与cTnⅠ关联性,对比感染组不同预后患者血清PCT、PSGL-1、sICAM-1、cTnⅠ水平,受试者工作特征(ROC)曲线分析各血清因子对预后的预测价值,采用Kaplan-Meier曲线进行生存分析。结果感染组血清PCT、PSGL-1、sICAM-1、cTnⅠ水平高于未感染组、对照组差异有统计学意义(P<0.05);合并基础性疾病、血清PCT、PSGL-1、sICAM-1、cTnⅠ是心外科ICU患者发生术后感染的独立危险因素(P<0.05);血清PCT、PSGL-1、sICAM-1与cTnⅠ呈正相关(P<0.05);感染第3、5天生存者血清PCT、PSGL-1、sICAM-1、cTnⅠ水平低于死亡者(P<0.05);感染第5 d cTnⅠ预测心外科ICU患者术后感染预后的AUC值最大,为0.804;随访28 d,血清PCT、PSGL-1、sICAM-1、cTnⅠ低危组、高危组的生存曲线对比,差异有统计学意义(P<0.05)。结论心外科ICU患者术后感染会引起血清PCT、PSGL-1、sICAM-1、c TnI异常表达,且表达水平与感染发生发展及预后有一定相关性,临床可通过监测上述血清因子表达超早期予以干预治疗,以改善预后。