腺苷脱氨酶对急性StanfordA型主动脉夹层患者术后短期死亡风险预测的研究

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Predictive Value of Adenosine Deaminase for Early Postoperative Death in Patients with Acute Stanford Type A Aortic Dissection

FANG Min ，ZHANG Xin1，CAO Yi1，WU Yunyan2，ZHAO Yongbo2，MA Dong1，3

（1.Schoolof Public Health，North China Universityof Scienceand Technology，Tangshan O6321o，HebeiChina； 2.Cardiac Surgery Department，The Fourth Hospitalof Hebei Medical University，Shijiazhuang O51Ooo，Hebei，China； 3.Department of Biochemistryand Molecular Biology，KeyLaboratory of Neural and Vascular Biology，Ministryof Education，and Hebei KeyLaboratoryof Cardiovascular Homeostasisand Aging，Hebei Medical UniversityShijiazhuang 050017，Hebei，China）

【Abstract】ObjectiveToinvestigate therelationshipbetween serumadenosine deaminase（ADA）levelsatadmissioninacute StanfordtypeAaoticdissectioAAAD）patintsdal-ausemotalitywit3daftersureryMetodsArrospectiveaalyisof 234patients whodiagnosedwithATAADadmitedtoTheFourthHospitalofHebeiMedicalUniversitybeteenNovember2013andDecember 2023.TheallasemortalityithnOdpostoperatioasfllodup.Lgisticregessionaalysisasuedtoentifidepeeisk factorsforin-hospitalmortalityinATAADpatnts.ROCcurvewasusedtoaessthpredictivevalueofADAfor3OdmortalityAAD patientswithteotialcutoffvalue.Kaplan-Meiersurvivalurvesereplotedbasedontheoptialutoffvalue，ndtelgnktestas usedtocompareiospitalmoraitmonggoupswitdintDlevels.UivarateCoegressowasplodfosolisf therelationshpeeAdmoralitRsutshultsoftivatelsticegesaisvealedosiie between serum ADA levelsat admission and in-hospital mortality in patients with ATAAD（ O R=1 .487，95% CI1.222＼～1.809）.The AUC was 0.744（ 95% CI 0. 669＼～0. 820， P<0.001 ），with a cutoff value of 9.65U/L ，a sensitivity of 57.1% ，and a specificity of 78.7% . Kaplan

Meiersurvivalcurveanalysisshowedawosein-hospitalsurvivalwithigherADAlevels.UnivariateCoxregresionsubroupanalysis demonstratedaefectivenessofhighADAlevelsomortalityacrossdiferentsubroups.ConclusionTheADAlevelsatdmisionn ATAAD patients may bea predictor associated with postoperativein-hospital mortality and the short-term prognosis.

Keywords】 Acute Stanford type A aortic dissection；Adenosine deaminase；In-hospital mortality

急性主动脉夹层（acuteaortic dissection，AAD）根据斯坦福分型可以分为A型、B型和非A非B型三种类型：在窦管交界处上方发生撕裂导致主动脉壁形成假腔，即为急性StanfordA型主动脉夹层（acuteStanford type A aorticdissection，ATAAD）[1]。（剩余9487字）