摘要
目的:研究血清中细胞炎症因子降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素6(IL-6)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和肿瘤坏死因子(TNF-α)在急性呼吸窘迫综合征(ARDS)患者预后预测中的作用。方法:107例ARDS患者按预后分为存活组42例和死亡组65例,比较两组患者血清PCT、CRP、IL6、NAGL和TNF-α水平,采用Logistic回归分析和绘制ROC曲线,评估细胞炎症因子对ARDS患者预后预测的价值。结果:死亡组血清PCT、IL-6、NGAL和TNFα水平分别为7.40±2.35ng/mL,11.41±4.08pg/mL,93.39±27.98ng/mL和12.56±3.77μg/L,高于存活组的5.10±1.46ng/mL,8.61±2.95pg/mL,59.57±21.44ng/mL和8.55±2.47μg/L,差异均有统计学意义(P<0.05)。多因素logistic回归分析显示PCT、IL6、NGAL、TNFα均可作为判断ARDS预后的指标。NGAL曲线下面积(AUC)为0.830(P<0.01),TNFαAUC为0.814(P<0.01),对ARDS预后具有良好的预测价值。PCT+IL6+NGAL+TNFα联合应用的AUC面积为0.940,高于单一因子预测价值。结论:血清NGAL、PCT、IL6以及TNF-α均可作为判断ARDS预后的指标,联合应用能够提高预测的准确性。
Objective: To investigate the role of serum Procalcitonin(PCT),C-reactive protein(CRP),Interleukin 6(IL6),Neutrophil Gelatinase-associated Lipocalin(NGAL) and Tumor necrosis factor(TNFα) in predicting the prognosis of patients with acute respiratory distress syndrome(ARDS).Methods: One hundred and seven ARDS patients from January2015 to June 2017 admitted to Taizhou People's hospital were divided into the survival group(42 cases) and the death group(65 cases).The indications of ARDS in two groups were analyzed by single factor analysis and logistic regression analysis.ROC curves were plotted for screening predictor of the prognosis of patients with ARDS.Result: The single factor comparison showed that the serum PCT、IL6、NGAL and TNFα was of statistical significance between the two groups.Logistic regression analysis showed that PCT、IL6、NGAL and TNFα can be used as predictors of the prognosis of patients with ARDS.ROC curve analysis showed that the area under the ROC curve(AUC) of NGAL was 0.830,P0.01,which is larger than AUC of PCT、IL6 and TNFα.The AUC area of PCT+IL6+NGAL+TNF was 0.940,which Indicated that the forecast value was higher than that of the single factor.Conclusion: The Serum NGAL,PCT,IL6 and TNFα can be used as prognostic markers to predict the prognosis of ARDS,and the combination of them can improve the accuracy of prognosis prediction.
出处
《交通医学》
2017年第5期425-428,共4页
Medical Journal of Communications