摘要
目的探究正五聚体素-3(PTX3)在急性呼吸窘迫综合征患者(ARDS)血浆中的表达水平及其在患者预后中的评估价值。方法选取113例ARDS患者,根据病情严重程度分为轻度(39例)、中度(43例)、重度(31例),另选取80例健康者作为对照组。采用酶联免疫法检测血浆PTX3水平,分析其与病情程度的关系,统计患者28 d死亡率;采用COX回归分析及Kaplan⁃Meier法分析PTX3与ARDS患者28 d死亡的关系,采用ROC曲线分析PTX3在ARDS预后中的评估价值。结果不同程度ARDS患者吸烟率、急性生理学及慢性健康状况评分Ⅱ(APACHEⅡ)、序贯器官衰竭评估(SOFA)、肺损伤评分(LIS)及血浆PTX3水平高于对照组,氧和指数(PaO2/FiO2)低于对照组,差异均有统计学意义(P<0.05)。死亡组患者血浆PTX3水平、APACHEⅡ评分、SOFA评分高于生存组,PaO2/FiO2低于生存组(P<0.05)。APACHEⅡ评分、SOFA评分、PaO2/FiO2、PTX3为影响ARDS患者预后的独立因素。PTX3低表达组生存期显著高于PTX3高表达组,差异有统计学意义(P<0.05)。PTX3对ARDS患者预后预测的AUC值为0.810。结论PTX3在ARDS患者血浆中升高,与病情程度有关,是影响ARDS患者28 d死亡的危险因素,对ARDS预后具有一定的预测价值。
Objective To investigate the expression of pentraxin 3(PTX3)in plasma of patients with acute respiratory distress syndrome(ARDS)and its prognostic value.Methods 113 patients with ARDS were selected and divided into mild group(39 cases),moderate group(43 cases)and severe group(31 cases)according to the severity of the disease.Another 80 healthy persons were selected as the control group.The plasma PTX3 level was detected by enzyme linked immunosorbent assay,and the relationship between PTX3 level and the severity of the disease was analyzed.The 28⁃day mortality rate was counted.COX regression analysis and Kaplan⁃Meier method were used to analyze the relationship between PTX3 and the 28⁃day mortality of ARDS patients,and the ROC was used to analyze the evaluation value of PTX3 in the prognosis of ARDS.Results The rate of smoking,acute physiological and chronic health assessmentⅡ(APACHE⁃Ⅱ),sequential organ failure assessment(SOFA),lung injury score(LIS)and PTX3 level of patients with ARDS were higher than those of the control group,and oxygenation index(PaO2/FiO2)was lower than those of the control group(P<0.05).The plasma PTX3 level,APACHE⁃Ⅱscore and SOFA score in the death group were higher than those in the survival group,while PaO2/FiO2 was lower than that in the survival group(P<0.05).APACHE⁃Ⅱscore,SOFA score,PaO2/FiO2,PTX3 were independent factors affecting the prognosis of ARDS patients.The survival time of PTX3 low expression group was significantly higher than that of PTX3 high expression group(P<0.05).The AUC value of PTX3 in predicting the prognosis of ARDS patients was 0.810.Conclusions PTX3 was increased in plasma of ARDS patients,which was related to the severity of the disease.PTX3 was a risk factor for 28 d mortality of ARDS patients,and had a certain predictive value for the prognosis of ARDS.
作者
常东歌
袁咏梅
张庆
刘畅
王宝玉
陈波
CHANG Dong⁃ge;YUAN Yong⁃mei;ZHANG Qing;LIU Chang;WANG Bao⁃yu;CHEN Bo(Department of Emergency,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou,Henan 450007;Cardiopulmonary Function Room,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou,Henan 450007,China)
出处
《热带医学杂志》
CAS
2020年第5期658-662,共5页
Journal of Tropical Medicine
基金
2017年河南省科技攻关项目(182102310098)。
