乳酸脱氢酶水平与三尖瓣外科手术患者术后重症时间延长发生的相关性分析

Correlation analysis of lactate dehydrogenase level and the occurrence of prolonged postoperative severe time in patients undergoing tricuspid valve surgery

朱婷 ¹何海林 ²古晓林 ²鲍荣幸 ²凌云¹

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作者信息

1. 南方医科大学附属广东省人民医院/广东省医学科学院心外重症监护一科,广东广州,510080
2. 南方医科大学附属广东省人民医院/广东省医学科学院心外重症监护二科,广东广州,510080
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摘要

目的探究乳酸脱氢酶(LDH)水平与三尖瓣外科手术患者术后重症时间延长发生的相关性.方法回顾性分析2018年1月至2019年6月在我院体外循环下进行三尖瓣外科手术的205例患者的临床资料,根据LDH水平将患者等分为低值组、中值组和高值组.采用单因素和多因素Logistic回归模型结合限制性立方样条(RCS)模型探讨LDH水平与术后重症时间延长发生的剂量反应曲线关系及相关性,使用受试者工作特征(ROC)曲线评估LDH水平对术后重症时间延长发生的预测价值.结果 RCS分析显示,LDH与术后重症时间延长发生风险之间呈线性关系(非线性检验P＞0.05).多因素校正模型2中,LDH每增加1个标准差则术后重症时间延长的发生风险增加56％(P=0.029);高值组术后重症时间延长的发生率比低值组高出2.54倍(P=0.036);LDH水平越高则术后重症时间延长的发生风险越高(P=0.021).LDH水平预测术后重症时间延长发生的AUC为0.701.结论较高的LDH水平与术后重症时间延长的发生风险增加有关,其对术后重症时间延长的发生具有较好的预测价值.

Abstract

Objective To explore the correlation between lactate dehydrogenase(LDH)level and the occurrence of prolonged postoperative severe time in patients undergoing tricuspid valve surgery.Methods The clinical data of 205 patients who underwent tricuspid valve surgery under extracorporeal circulation in our hospital from January 2018 to June 2019 were retrospectively analyzed.According to the LDH level,the patients were divided into low value group,median value group and high value group.Univariate and multivariate Logistic regression models combined with restricted cubic splines(RCS)model were used to explore the dose-response curve relationship and correlation between LDH level and prolonged postoperative severe time.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of LDH level for the occurrence of prolonged postoperative severe time.Results RCS analysis showed that there was a linear relationship between LDH and the risk of prolonged postoperative severe time(non-linear test P＞0.05).In multivariate adjusted model 2,for each standard deviation increase in LDH,the risk of prolonged postoperative severe time increased by 56％(P=0.029);the incidence of prolonged postoperative severe time in the high value group was 2.54 times higher than that in the low value group(P=0.036);the higher the LDH level,the higher the risk of prolonged postoperative severe time(P=0.021).The AUC of LDH level in predicting the occurrence of prolonged postoperative severe time was 0.701.Conclusion The higher LDH level is related to the increased risk of prolonged postoperative severe time,and has a good predictive value for the occurrence of prolonged postoperative severe time.

关键词

乳酸脱氢酶/重症监护时间/三尖瓣/心脏外科手术

Key words

lactate dehydrogenase/intensive care time/tricuspid valve/cardiac surgical procedures

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出版年

2024

临床医学研究与实践

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