基于炎症的细胞比率超越白细胞计数预测EVAR和TEVAR后植入综合征。

IF 4.9 2区 生物学
Ebubekir Sönmez, İzatullah Jalalzai, Ümit Arslan
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引用次数: 0

摘要

植根后综合征(PIS)是血管内支架植入术(EVAR和TEVAR)后的早期炎症反应,以培养阴性发热和白细胞增多为特征。患者术前的炎症状态被认为在其发展中起核心作用。本研究旨在评估系统性炎症反应指数(SIRI)和嗜酸性粒细胞与淋巴细胞比值(ELR)是否可以作为PIS的术前预测指标。前瞻性记录300例主动脉瓣植入术患者的临床资料和术前24小时、术后24小时、72小时和术后1周的实验室结果。PIS定义为培养阴性发热≥37.8°C,并伴有白细胞计数≥12,000/µL。基于全血细胞计数(SIRI和ELR)的炎症指标,以及血清c反应蛋白(CRP)和白蛋白水平,在PIS患者和非PIS患者之间进行比较。采用Logistic回归和受试者工作特征(ROC)分析确定独立预测因子。55例(18.3%)患者发生PIS。PIS患者更年轻(70.1±8.6岁vs. 72.7±7.3岁;p = 0.042),动脉瘤直径和壁栓厚度更大。术前,PIS患者的白细胞计数、SIRI和CRP水平明显较高,而ELR和白蛋白水平较低。多变量分析显示,较大的动脉瘤直径(OR: 1.2; 95% CI: 1.0-1.3; p = 0.003)、较大的壁栓厚度(OR: 1.3; 95% CI: 1.0-1.6; p = 0.012)、EVAR手术(OR: 3.7; 95% CI: 1.2-6.3; p = 0.033)、较高的SIRI (OR: 1.9; 95% CI: 1.2-3.1; p = 0.005)和较高的CRP (OR: 1.4; 95% CI: 1.1-3.2; p = 0.003)与PIS显著相关。相反,年龄增加、较高的ELR和较高的白蛋白水平与PIS风险降低相关。从标准实验室测试中常规获得的简单生物标志物可以对PIS的术前预测和术后识别做出有意义的贡献。将它们整合到风险分层模型中,并根据明确的诊断标准进行确认,将需要在更大的、多中心的研究中进行验证。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Inflammation-Based Cell Ratios Beyond White Blood Cell Count for Predicting Postimplantation Syndrome After EVAR and TEVAR.

Inflammation-Based Cell Ratios Beyond White Blood Cell Count for Predicting Postimplantation Syndrome After EVAR and TEVAR.

Inflammation-Based Cell Ratios Beyond White Blood Cell Count for Predicting Postimplantation Syndrome After EVAR and TEVAR.

Postimplantation syndrome (PIS) is an early inflammatory response following endovascular stent-graft implantation (EVAR and TEVAR), defined by culture-negative fever and leukocytosis. The patient's preoperative inflammatory status is thought to play a central role in its development. This study aimed to evaluate whether the systemic inflammatory response index (SIRI) and the eosinophil-to-lymphocyte ratio (ELR) can serve as preoperative predictors of PIS. Clinical data from 300 patients who underwent aortic endograft implantation and laboratory results obtained 24 h before the procedure, and at 24 h, 72 h, and 1 week postoperatively, were prospectively recorded. PIS was defined as culture-negative fever ≥ 37.8 °C accompanied by leukocytosis ≥ 12,000/µL. Inflammation-based indices derived from complete blood count (SIRI and ELR), along with serum C-reactive protein (CRP) and albumin levels, were compared between patients with and without PIS. Logistic regression and receiver operating characteristic (ROC) analyses were performed to identify independent predictors. PIS developed in 55 patients (18.3%). Patients with PIS were younger (70.1 ± 8.6 vs. 72.7 ± 7.3 years; p = 0.042) and had larger aneurysm diameters and greater mural thrombus thickness. Preoperatively, leukocyte count, SIRI, and CRP levels were significantly higher in patients who developed PIS, whereas ELR and albumin levels were lower. Multivariable analysis showed that a larger aneurysm diameter (OR: 1.2; 95% CI: 1.0-1.3; p = 0.003), greater mural thrombus thickness (OR: 1.3; 95% CI: 1.0-1.6; p = 0.012), EVAR procedure (OR: 3.7; 95% CI: 1.2-6.3; p = 0.033), elevated SIRI (OR: 1.9; 95% CI: 1.2-3.1; p = 0.005), and higher CRP (OR: 1.4; 95% CI: 1.1-3.2; p = 0.003) were significantly associated with PIS. In contrast, increasing age, higher ELR, and higher albumin levels were associated with a reduced risk of PIS. Simple biomarkers routinely obtained from standard laboratory tests can contribute meaningfully to the preoperative prediction and postoperative identification of PIS. Their integration into risk stratification models and confirmation against definitive diagnostic criteria will require validation in larger, multicenter studies.

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期刊介绍: The International Journal of Molecular Sciences (ISSN 1422-0067) provides an advanced forum for chemistry, molecular physics (chemical physics and physical chemistry) and molecular biology. It publishes research articles, reviews, communications and short notes. Our aim is to encourage scientists to publish their theoretical and experimental results in as much detail as possible. Therefore, there is no restriction on the length of the papers or the number of electronics supplementary files. For articles with computational results, the full experimental details must be provided so that the results can be reproduced. Electronic files regarding the full details of the calculation and experimental procedure, if unable to be published in a normal way, can be deposited as supplementary material (including animated pictures, videos, interactive Excel sheets, software executables and others).
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