摘要
目的探究血清表面活性剂蛋白D(SPD)、甘露糖水平预测急性呼吸窘迫综合征(ARDS)患者预后的价值。方法回顾性收集2020年2月—2022年3月山西白求恩医院呼吸与危重症医学科诊治ARDS患者112例(ARDS组)的临床资料,根据病情程度分为轻度亚组(n=42)、中度亚组(n=38)、重度亚组(n=32),又根据患者28 d生存预后分为生存亚组(n=81)和死亡亚组(n=31),以同期健康体检者60例为健康对照组。采用酶联免疫吸附试验检测血清SPD、甘露糖水平;多因素Logistic回归分析ARDS患者28 d死亡预后影响因素;采用受试者工作特征(ROC)曲线分析血清SPD、甘露糖预测ARDS患者预后的价值。结果ARDS组患者血清SPD、甘露糖水平低于健康对照组(t=26.641、22.185,P均<0.001);轻度亚组、中度亚组和重度亚组血清SPD、甘露糖水平依次降低(F/P=142.650/<0.001,84.621/<0.001);与生存亚组比较,死亡亚组ARDS患者SOFA评分、APACHEⅡ评分升高,血清SPD、甘露糖降低(t/P=4.366/<0.001,6.470/<0.001,6.099/<0.001,8.586/<0.001);SOFA评分升高、APACHEⅡ评分升高是影响ARDS患者预后的危险因素[OR(95%CI)=1.423(1.088~1.862),1.511(1.140~2.004)],血清SPD升高、甘露糖升高是保护因素[OR(95%CI)=0.564(0.445~0.715),0.618(0.474~0.807)];血清SPD、甘露糖及二者联合预测ARDS患者28 d死亡预后的AUC分别为0.826、0.895、0.949,二者联合的AUC大于单指标检测(Z=5.021、4.432,P<0.001、0.002)。结论ARDS患者血清SPD、甘露糖水平降低,两者与患者病情严重程度相关,两项联合能有效评估ARDS患者的预后。
Objective The purpose of this study is to investigate the predictive value of serum surfactant protein D(SPD)and mannose levels in patients with acute respiratory distress syndrome(ARDS)in terms of prognosis.Methods A retrospective collection was conducted on 112 ARDS patients(ARDS group)who received treatment in Respiratory and Critical Care Medicine Department of Shanxi Norman Bethune Hospital(Shanxi Academy of Medical Sciences)from February 2020 to March 2022.According to the severity of the ARDS patients,they were divided into mild subgroup(n=42),moderate subgroup(n=38),and severe subgroup(n=32),as well as survival subgroup(n=81)and death subgroup(n=31)based on the prognosis.60 healthy individuals were taken as the healthy control group.Enzyme-linked immunosorbent assay was used to detect serum SPD and mannose levels.The prognostic factors of ARDS patients and the prognostic evaluation value of serum SPD and mannose were analyzed using statistical analysis.Results The serum SPD and mannose levels in the ARDS group were(162.21±21.78)μg/L and(130.65±19.90)ng/L,respectively,lower than those in the healthy control group(252.34±45.70)μg/L and(227.14±37.21)ng/L(t=26.641,22.185,P<0.001).The serum levels of SPD and mannose in the mild,moderate,and severe subgroups decreased significantly in sequence(F/P=142.650/<0.001,84.621/<0.001).Compared with the healthy control group,the SOFA score and APACHEⅡscore of ARDS patients in the death group were higher,while serum SPD and mannose were lower(t/P=4.366/<0.001,6.470/<0.001,6.099/<0.001,8.586/<0.001).SOFA score and APACHEⅡscore were risk factors affecting the 28 day mortality prognosis of ARDS patients,while serum SPD and mannose were protective factors[OR(95%CI)=1.423(1.088-1.862),1.511(1.140-2.004),0.564(0.445-0.715),0.618(0.474-0.807)].The area under the curve(AUC)for predicting the 28 day mortality prognosis of ARDS patients with serum SPD and mannose combination was 0.949,which was greater than single indicator detection of 0.826 and 0.895(Z=5.021,4.432,P<0.001,0.002).Conclusion The serum levels of SPD and mannose in ARDS patients decrease,which are correlated with the severity of the patient's condition.The combination of serum SPD and mannose has good predictive value for the prognosis of ARDS patients.
作者
魏瑶娜
段炜
梁磊
王鹏飞
Wei Yaona;Duan Wei;Liang Lei;Wang Pengfei(Department of Respiratory and Critical Care,Shanxi Norman Bethune Hospital(Shanxi Academy of Medical Sciences),Shanxi Province,Taiyuan 030000,China)
出处
《疑难病杂志》
CAS
2024年第8期924-928,共5页
Chinese Journal of Difficult and Complicated Cases
基金
山西省卫生健康科研课题(2019M041)。
作者简介
通信作者:王鹏飞,E-mail:wangpengfei724@126.com。
