■急性主动脉综合征(AAS)是一种危及生命的疾病,其中主动脉壁的完整性发生断裂。γ-谷氨酰转移酶与淋巴细胞比率(GLR)被认为是肝硬化的危险因素,纤维化,和肝细胞癌。然而,没有GLR和AAS的临床报告。我们试图确定中国南方潮汕地区患者的GLR水平是否与AAS相关。
■本研究共招募2,384例患者,根据胸腹主动脉CT血管造影结果分为AAS组和非AAS组。采用单因素和多因素logistic回归分析AAS发生的危险因素。应用ROC评估D-二聚体的值,仅GLR,或组合用于AAS的诊断。并进行1:1倾向得分匹配分析。
■多元物流回归分析表明,男性,年龄,高血压,糖尿病,肌酐,D-二聚体,在倾向评分匹配前队列中,GLR是AAS患者的独立危险因素。在倾向得分匹配后,它显示D-二聚体,GLR[OR3.558(1.891,6.697);p<0.001]是AAS患者的独立危险因素。在倾向得分匹配之前,GLR曲线下面积(AUC)为0.822,D-二聚体为0.767。当两种临床背景都调整后,GLR的AUC为0.773,D-二聚体为0.631。GLR显示出高特异性(80.5%和77.1%),和D-二聚体在倾向评分匹配前后队列中显示出较高的敏感性(84.7%和73.6%)。
■GLR和D-二聚体是急性主动脉综合征的独立危险因素。D-二聚体与GLR联合诊断急性主动脉综合征比单一指标更有价值。
UNASSIGNED: Acute aortic syndrome (AAS) is a life-threatening condition in which there is a fracture in the integrity of the aortic wall. gamma-glutamyl transferase to lymphocyte ratio (GLR) is recognized as a risk factor for liver cirrhosis, fibrosis, and hepatocellular carcinoma. However, there are no clinical reports of GLR and AAS. We attempted to determine whether GLR level is associated with AAS in patients from the Chaoshan region of southern China.
UNASSIGNED: A total of 2,384 patients were recruited in this study and were divided into AAS and no-AAS groups according to the results of CT angiography of the thoracoabdominal aorta. Univariate and multivariate logistic regression was performed to identify risk factors for the occurrence of AAS. ROC was applied to assess the value of D-Dimer, GLR alone, or in combination for the diagnosis of AAS. And a 1:1 propensity score-matched analysis was performed.
UNASSIGNED: Multivariate logistics regression analysis indicated that male, age, hypertension, diabetes, creatinine, D-dimer, and GLR were independent risk factors of AAS patients in the before propensity score-matching cohort. After propensity score-matching, it showed that D-dimer, GLR [OR 3.558(1.891, 6.697); p < 0.001] were independent risk factors of AAS patients. Before propensity score-matching, the area under the curve (AUC) was 0.822 of GLR and 0.767 of D-dimer. When both clinical backgrounds were adjusted, the AUC was 0.773 of GLR and 0.631 of D-dimer. GLR showed high specificity (80.5% and 77.1%), and D-dimer showed high sensitivity (84.7% and 73.6%) in the before and after propensity score-matching cohort.
UNASSIGNED: GLR and D-dimer were independent risk factors of acute aortic syndrome. D-dimer in combination with GLR is more valuable than a single indicator for diagnosing acute aortic syndrome.