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血清钙水平低增加SCA风险

By LabMedica International staff writers
Posted on 06 Dec 2017
90%以上患者的突发性心脏骤停(SCA)致命,死于SCA的男性有超过一半、女性近70%此前没有临床心脏病史。它是美国的主要死因之一,比任何一种癌症致死的人都多。

根据现行指导意见,许多SCA患者不算高风险者。这些冷峻的事实迫使人们寻找相对不贵的简单方法来发现SCA风险较高的人。血液中钙水平很容易监测,钙水平较低的人比钙水平高者更可能发生SCA。

一组科学家与美国加利福尼亚州洛杉矶市西达斯-西奈心脏研究所的科学家合作,在对267名SCA患者和445名对照者的日常护理过程中测量了血清中的钙水平。在所有SCA病例心脏骤停的90天前测量血清钙水平。根据每名患者的血清白蛋白水平校正总血清钙,估计一个与生理更相关的钙水平。如果病人的年龄是18岁或以上,且已知肌酐清除率(CrCl)和血清电解质水平,就纳入研究;通过分析肌酐清除率和血清电解质水平能够调节肾功能。

科学家发现,SCA患者中非裔美国人、糖尿病患者、慢性阻塞性肺病患者和慢性肾病患者的比例远远高于对照组。SCA患者血液透析的几率也高于对照组。此外,给SCA患者开的利尿剂也比β阻滞剂利用率相同的对照者多,尤其是髓袢利尿剂。血钙水平低于8.95毫克/分升与SCA几率比水平高于9.55毫克/分升时升高1.3倍有关(风险比2.33)。

该研究的论文发表于2017年9月21日的《梅奥临床学报》(Mayo Clinic Proceedings)杂志。领衔作者、西达斯-西奈心脏研究所博士后Hirad Yarmohammadi大夫说:“我们的研究显示,如果血清钙水平较低,即使在正常范围内,也会增加突发性心脏骤停的风险。虽然我们的成果这时还不能用于临床,但已向目标——通过更好地预测风险来改进病人护理——迈出了一大步。”

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西达斯-西奈心脏研究所

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