摘要
目的观察急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者血清Clara细胞分泌蛋白16(clara cell protein-16,CC-16)、单核细胞趋化蛋白1(monocyte chemotaxis protein-1,MCP-1)水平的变化,并探讨其与病情严重程度和预后的关系。方法选取长治市人民医院2017年1月至2018年3月收治的ARDS患者114例作为此次研究对象,按照ARDS轻重程度分为轻度组(37例)、中度组(41例)和重度组(36例),并选择60名门诊体检健康者为对照组,记录4周内患者的生存情况,并根据生存情况将患者分为生存组(65例)和病死组(49例)。分析各组年龄、性别、体质量指数(body mass index,BMI)、吸烟史、急性生理学及慢性健康状况评分Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)、序贯器官衰竭评估(sequential organ failure assessment,SOFA)评分、血清CC-16及MCP-1水平的差异,分析血清CC-16、MCP-1水平与ARDS患者病情和预后的关系。结果随着疾病严重程度上升,ARDS患者APACHEⅡ评分、SOFA评分以及血清CC-16、MCP-1水平均明显上升,差异均有统计学意义(F值分别为1 216.886、1 339.247、290.879、417.262,P值均为0.000),吸烟史亦有统计学意义(χ^2=19.106,P=0.000)。病死组患者APACHEⅡ评分、SOFA评分以及血清CC-16、MCP-1水平分别为(22.13±2.47)分、(15.09±1.97)分、(23.85±4.27)μg/L、(36.64±5.21)ng/L,均明显高于生存组的(18.25±2.35)分、(13.23±2.03)分、(17.34±4.13)μg/L、(27.93±4.88)ng/L,差异均有统计学意义(t值分别为8.538、4.905、8.211、9.146,P值均为0.000)。Pearson相关性分析显示,ARDS患者血清CC-16水平与MCP-1水平呈正相关(r=0.589,P=0.000),同时CC-16、MCP-1均与APACHEⅡ评分、SOFA评分以及病死率呈正相关关系(CC-16:r值分别为0.504、0.549、0.472,P值分别为0.000、0.000、0.012;MCP-1:r值分别为0.493、0.528、0.435,P值分别为0.006、0.000、0.025)。Logistic回归分析亦显示:APACHEⅡ评分(OR=3.083,95%CI:0.025~1.364,P<
Objective To observe the changes of serum clara cell protein-16(CC-16)and monocyte chemotaxis protein-1(MCP-1)level in patients with acute respiratory distress syndrome(ARDS)and to explore their relationship with the disease severity and prognosis of ARDS.Methods One hundred and fourteen patients with ARDS who were admitted to Changzhi People′s hospital from January 2017 to March 2018 were selected as the subjects.They were divided into mild group(n=37),moderate group(n=41)and severe group(n=36)according to the severity of ARDS.Sixty healthy persons in out-patient examination were selected as control group.The survival situation of patients in 4 weeks were recorded,the patients were divided into survival group(n=65)and death group(n=49)according to their survival situation.The age,gender,body mass index(BMI),smoking history,acute physiology and acute physiology and chronic health evaluation II(APACHE II)score,sequential organ failure assessment(SOFA)score,serum CC-16 and MCP-1 level were analyzed in each group.The relationship between serum CC-16,MCP-1 level and disease and prognosis of patients with ARDS were analyzed.Results With the increase of disease severity,APACHE II score,SOFA score and serum CC-16,MCP-1 level in patients with ARDS were significantly increased.The differences were statistically significant(F=1 216.886,1 339.247,290.879,417.262;all P=0.000).The APACHE II score,SOFA score and serum CC-16,MCP-1 levels in the death group were(22.13±2.47)scores,(15.09±1.97)scores,(23.85±4.27)μg/L,(36.64±5.21)ng/L respectively,which were significantly higher than those in the survival group(18.25±2.35)scores,(13.23±2.03)scores,(17.34±4.13)μg/L,(27.93±4.88)ng/L,the differences were statistically significant(t=8.538,4.905,8.211,9.146;all P=0.000).Pearson correlation analysis showed that there was a positive correlation between serum CC-16 level and MCP-1 level in patients with ARDS(r=0.589,P=0.000).Meanwhile,the CC-16,MCP-1 were positive correlation with APACHE II score,SOFA score and mortality(CC-16:
作者
成亚东
刘辉
崔琛
王爱文
王杨周
王芳
李晓辉
高艳芳
吴晨栋
Cheng Yadong;Liu Hui;Cui Chen;Wang Aiwen;Wang Yangzhou;Wang Fang;Li Xiaohui;Gao Yanfang;Wu Chendong(Department of intensive care unit,Changzhi People′s Hospital,Shanxi Province,Changzhi 046000,China)
出处
《中国综合临床》
2019年第4期289-294,共6页
Clinical Medicine of China
基金
山西省医学科技攻关计划项目(YQ20160489).
