全身凝血-炎症标志物在预测急性A型主动脉夹层预后中的价值研究进展

宋鑫宇; 左亚群; 陈哲平; 金延武

doi:10.16766/j.cnki.issn.1674-4152.003646

全身凝血-炎症标志物在预测急性A型主动脉夹层预后中的价值研究进展

doi: 10.16766/j.cnki.issn.1674-4152.003646

山东大学第二医院麻醉科，山东济南 250033

详细信息

通讯作者:
金延武，E-mail：jinyanwu_aa@163.com

中图分类号: R543.1
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出版历程
- 收稿日期: 2023-10-12
- 网络出版日期: 2024-11-19

Progress in the study of the value of systemic coagulation-inflammatory markers in predicting the prognosis of acute type A aortic dissection

Department of Anesthesiology, the Second Hospital of Shandong University, Jinan, Shandong 250033, China

摘要

摘要: 急性A型主动脉夹层(ATAAD)是以主动脉解剖病理改变、全身炎症反应、凝血功能紊乱为特征的一种复杂的、极为凶险的心血管疾病，对人类的生命和健康构成严重威胁。目前高龄、肥胖、术前神经损伤、大量输血、手术时间、组织器官灌注不良以及由于心脏压塞或冠状动脉灌注不良导致的血流动力学损害等危险因素被认为是ATAAD患者死亡的独立预测因子，但这些危险因素仍不能满足临床实践的需要。ATAAD常并存炎症反应和凝血功能障碍，凝血与炎症反应之间存在着复杂的交互作用，共同参与ATAAD的发生发展。研究报道，凝血与炎症标志物有助于评估ATAAD患者的预后，将其纳入临床预测模型(CPMs)相较于传统预测模型的预测效能更佳。为此，本文回顾并综述全身凝血－炎症标志物与ATAAD患者预后的相关性及其在预测模型建立中的作用研究进展，为临床早期诊断、早期危险分层、早期临床干预提供新思路。
- 急性A型主动脉夹层 /
- 预后 /
- 凝血 /
- 炎症 /
- 标志物 /
- 预测价值 /
- 临床预测模型
Abstract: Acute type A aortic dissection (ATAAD) is a complex and extremely dangerous cardiovascular disease characterized by pathological changes of aortic anatomy, systemic inflammatory response, and coagulation dysfunction, which poses a serious threat to human life and health. Currently, risk factors such as advanced age, obesity, preoperative nerve injury, massive blood transfusion, operation time, poor tissue and organ perfusion, and hemodynamic damage caused by cardiac tamponade or poor coronary perfusion are considered to be independent predictors of death in patients with ATAAD. However, these risk factors still do not meet the needs of clinical practice. In ATAAD cases, inflammation reaction and coagulation dysfunction often coexist, the complex interactions between coagulation and inflammation playing a role in the occurrence and development of ATAAD. Recent studies have shown that markers of coagulation and inflammation can aid in assessing the prognosis of ATAAD patients while enhancing predictive performance when incorporated into clinical prediction models (CPMs), surpassing traditional prediction models. Therefore, this article aims to review and summarize the relevance of systemic coagulation-inflammatory markers to the prognosis of ATAAD patients, as well as their role in establishing prediction models. This research progress provides novel insights for early clinical diagnosis, early risk stratification, and early clinical intervention.
- Acute type A aortic dissection /
- Prognosis /
- Coagulation /
- Inflammation /
- Biomarkers /
- Predictive value /
- Clinical prediction model

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