摘要
目的 探讨急性呼吸窘迫综合征(ARDS)患者肺泡巨噬细胞(AM)吞噬功能改变对ARDS预后不良的预测价值。方法 选取本院2020年1月至2023年1月收治的248例ARDS患者作为研究对象,检测AM吞噬功能(包括中性红吞噬能力、酸性磷酸酶活性)。根据患者入院28d内的存活情况将其分为预后不良组(81例)和预后良好组(167例),并比较两组AM吞噬功能,采用多因素Logistic回归分析ARDS患者预后不良的影响因素,并采用受试者工作特征曲线(ROC)分析AM吞噬功能对ARDS患者预后不良的预测价值。结果 预后不良组急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)、序贯器官衰竭评估(SOFA)评分、尿素氮以及重度柏林分度占比均高于预后良好组(P<0.05),白蛋白(Alb)、氧合指数、中性红吞噬能力、酸性磷酸酶活性均低于预后良好组(P<0.05);多因素Logistic回归分析结果显示,APACHEⅡ评分及SOFA评分降低、重度柏林分度均是ARDS患者预后不良的危险因素(P<0.05),Alb、氧合指数、中性红吞噬能力、酸性磷酸酶活性升高均是其保护因素(P<0.05);ROC结果显示,中性红吞噬能力、酸性磷酸酶活性联合预测ARDS预后不良的灵敏度和AUC分别为91.36%、0.927,均高于单独预测(P<0.05),联合预测的特异度与单独预测差异无统计学意义(P>0.05)。结论 ARDS患者AM中性红能力、酸性磷酸酶活性均为ARDS患者预后不良的影响因素,且对ARDS患者预后不良的预测价值较好。
Objective To observe the changes of alveolar macrophage(AM)phagocytosis in patients with acute respiratory distress syndrome(ARDS),and to analyze its predictive value for poor prognosis of ARDS.Methods A total of 248 patients with ARDS admitted to our hospital from January 2020 to January 2023 were selected as the research objects,and the AM phagocytosis function(including neutral red phagocytosis ability and acid phosphatase activity)was detected.According to the survival of patients within 28 days after admission,they were divided into poor prognosis group(81 cases)and good prognosis group(167 cases),and the AM phagocytosis function of the two groups was compared.Multivariate Logistic regression was used to analyze the influencing factors of poor prognosis in ARDS patients,and the receiver operating characteristic curve(ROC)was used to analyze the predictive value of AM phagocytic function for poor prognosis in patients with ARDS.Results The acute physiology and chronic health evaluation II(APACHE II)score,sequential organ failure assessment(SOFA)score,urea nitrogen and the proportion of severe Berlin index in the poor prognosis group were higher than those in the good prognosis group(P<0.05),and albumin(Alb),oxygenation index,neutral red phagocytosis and acid phosphatase activity were lower than those in the good prognosis group(P<0.05).Multivariate Logistic regression analysis showed that the decreased of APACHE II score and SOFA score,and severe Berlin index were risk factors for poor prognosis of ARDS patients(P<0.05),and the increased of Alb,oxygenation index,neutral red phagocytosis and acid phosphatase activity were protective factors(P<0.05).ROC results showed that the sensitivity and AUC of neutral red phagocytosis and acid phosphatase activity in predicting the poor prognosis of ARDS were 91.36%and 0.927,respectively,which were higher than those predicted alone(P<0.05).and there was no significant difference in specificity between combined prediction and single prediction(P>0.05).Conclusion AM neutral red ability and acid phosphatase activity in ARDS patients are influencing factors for poor prognosis in ARDS patients,and have good predictive value for poor prognosis in ARDS patients.
作者
宋浩
SONG Hao(Department of Critical Care Medicine,The First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,Henan Province,China)
出处
《罕少疾病杂志》
2025年第1期57-59,共3页
Journal of Rare and Uncommon Diseases
关键词
急性呼吸窘迫综合征
肺泡
巨噬细胞
吞噬功能
预后不良
预测价值
Acute Respiratory Distress Syndrome
Alveoli
Macrophages
Phagocytic Function
Poor Prognosis
Predictive Value
