浙江医学2025，Vol.47Issue(9)：903-908,6.DOI:10.12056/j.issn.1006-2785.2025.47.9.2024-1125
血清离子钙和Ⅲ型前胶原氨基端原肽水平对心源性休克患者死亡的预测效能分析
Prediction of serum ionized calcium and procollagen Ⅲ N-terminal peptide levels in death of patients with cardiogenic shock
摘要
Abstract
Objective To analyze the predictive efficacy of serum ionic calcium(iCa)and Ⅲ procollagen amino-terminal propeptide(PⅢNP)for death in patients with cardiogenic shock(CS).Methods A total of 181 patients with CS admitted to the 986th Hospital of the People's Liberation Army Air Force from January 2021 to October 2023 were retrospectively selected as the CS group.According to the clinical outcomes within 30 days after admission,they were divided into a death subgroup(99 cases)and a survival subgroup(82 cases).Additionally,92 healthy individuals who underwent physical examinations in the same hospital during the same period were selected as the control group.The general data of the CS group and the control group were compared.The serum iCa level was detected by o-methylphenolphthalein complexone colorimetric method,and the serum PⅢNP level was detected by enzyme-linked immunosorbent assay.The Intra-Aortic Balloon Pump in Cardiogenic Shock Ⅱ(IABP-SHOCK Ⅱ)Score of the CS group was evaluated.Spearman correlation analysis was used to analyze the correlation between the levels of serum iCa and PⅢNP in CS patients and the IABP-SHOCK Ⅱ score.Multivariate logistic regression was used to analyze the factors influencing the death of patients with CS,and the ROC curve was drawn to analyze the predictive efficacy of serum iCa and PⅢNP levels for the death of patients with CS.Results The age of the death subgroup was greater than that of the survival subgroup,and the levels of lactic acid,cardiac troponin I,and N-terminal pro-brain natriuretic peptide(NT-proBNP)were higher than those of the survival subgroup,the differences of which were statistically significant(all P＜0.05).The serum iCa level in the death subgroup was lower than that of the survival subgroup,while the PⅢNP level was higher than that in the survival subgroup,the differences of which were statistically significant(both P＜0.001).The IABP-SHOCK Ⅱ score in the CS group was negatively correlated with the serum iCa level,and positively correlated with the PⅢNP level(rs=-0.803,0.814,respectively;both P＜0.001).Increased age,elevated lactate,elevated NT-proBNP,and elevated PⅢNP were all independent risk factors for death in patients with CS,and elevated iCa was an independent protective factor(all P＜0.05).The AUC of serum iCa combined with PⅢNP in predicting the death of CS patients was 0.857,which was greater than 0.776 and 0.770 predicted by serum iCa and PⅢNP alone(both P＜0.05).Conclusion The decrease of serum iCa level and the increase of PⅢNP level are closely related to the poor short-term prognosis of CS patients.The combination of the two has a higher efficacy in predicting the death of CS patients.关键词
心源性休克/离子钙/Ⅲ型前胶原氨基端原肽/预后Key words
Cardiogenic shock/Ionized calcium/Procollagen ⅢN-terminal peptide/Prognosis引用本文复制引用
邹倩,叶飞林,徐杰,李玉峰,袁彩霞,李慧,鲁轩浩..血清离子钙和Ⅲ型前胶原氨基端原肽水平对心源性休克患者死亡的预测效能分析[J].浙江医学,2025,47(9):903-908,6.基金项目
陕西省自然科学基金研究计划项目(2021JM-230) （2021JM-230）
