摘要
目的研究脓毒症并发急性呼吸窘迫综合征(ARDS)患者血清可溶性血栓调节蛋白(sTM)、可溶性尿激酶型纤溶酶原激活物受体(suPAR)、血管生成素-2(Ang-2)水平与炎症因子及预后的关系。方法以该院2018年2月至2020年2月收治的315例脓毒症患者为研究对象,根据入院72 h内是否并发ARDS分为ARDS组(103例)和非ARDS组(212例)。检测并比较2组血清sTM、suPAR、Ang-2、C-反应蛋白(CRP)、白细胞介素-6(IL-6)水平,采用Pearson相关分析血清sTM、suPAR、Ang-2水平与CRP、IL-6的关系。ARDS组患者根据入院28 d是否死亡分为死亡组(44例)和存活组(59例),采用单因素及多因素Logistic回归模型分析ARDS组患者预后的影响因素。结果ARDS组患者血清sTM、suPAR、Ang-2、CRP、IL-6水平高于非ARDS组,差异均有统计学意义(P<0.05)。Pearson相关分析显示,ARDS组患者血清sTM、suPAR、Ang-2水平与CRP、IL-6均呈正相关(r>0.500,P<0.05)。多因素Logistic回归模型分析显示,急性生理学和慢性健康状况评价Ⅱ评分≥25分、序贯器官衰竭评估评分≥16分、重度ARDS、机械通气时间≥5 d及血清sTM、suPAR、Ang-2、CRP、IL-6水平升高均是ARDS组患者死亡的危险因素(OR>1,P<0.05)。结论脓毒症并发ARDS患者血清sTM、suPAR、Ang-2水平异常升高,且和炎症因子呈正相关,对上述指标进行检测可能有助于预后判断。
Objective To study the relationship between the serum levels of soluble thrombolregulatory protein(sTM),soluble urokinase-type plasminogen activator receptor(suPAR)and angiopoietin-2(Ang-2)levels and inflammatory factors and prognosis in patients with sepsis complicated with acute respiratory distress syndrome(ARDS).Methods A total of 315 patients with sepsis who were admitted to this hospital from February 2018 to February 2020 were selected as the research objects.They were divided into the ARDS group(103 cases)and the non-ARDS group(212 cases)according to whether ARDS occurred within 72 hours after admission.The serum levels of sTM,suPAR,Ang-2,C-reactive protein(CRP)and interleukin-6(IL-6)were detected and compared between the two groups.Pearson correlation was used to analyze the relationship among the serum levels of sTM,suPAR,Ang-2 and CRP and IL-6.Patients in ARDS group were divided into the death group(44 cases)and the survival group(59 cases)according to whether they died on the twenty-eighth days after admission.Univariate and multivariate Logistic regression models were used to analyze the influencing factors of prognosis of patients in the ARDS group.Results The serum levels of sTM,suPAR,Ang-2,CRP and IL-6 in the ARDS group were higher than those in the non-ARDS group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that the serum levels of sTM,suPAR and Ang-2 were positively correlated with CRP and IL-6 in the ARDS group(r>0.500,P<0.05).Multivariate Logistic regression model analysis showed that acute physiology and chronic health status assessmentⅡscore≥25 points,sequential organ failure assessment score≥16 points,severe ARDS,mechanical ventilation time≥5 days and the increase of the serum levels of STM,suPAR,Ang-2,CRP and IL-6 were the risk factors of death in ARDS group(OR>1,P<0.05).Conclusion The serum levels of sTM,suPAR and Ang-2 in patients with sepsis complicated with ARDS are abnormally elevated,and they are positively correlated with inflammatory factors.The detection of these indicators may be helpful to judge the prognosis.
作者
孙会志
孙海英
李亚平
SUN Huizhi;SUN Haiying;LI Yaping(Department of Critical Medicine,Dandong First Hospital,Dandong,Liaoning 118000,China)
出处
《检验医学与临床》
CAS
2022年第8期1075-1079,共5页
Laboratory Medicine and Clinic
