摘要
目的探讨血浆S100钙结合蛋白A4(S100A4)、S100钙结合蛋白A8(S100A8)与急性Stanford A型主动脉夹层(ATAAD)患者术后急性肺损伤(ALI)的关系。方法于2018年1月至2023年6月选取我院心血管外科收治的135例ATAAD患者,所有患者均接受手术治疗,术前检测血浆S100A4、S100A8水平,术后统计ALI发生情况。多因素Logistic回归分析影响ATAAD患者术后ALI的因素,绘制受试者工作特征(ROC)曲线分析血浆S100A4、S100A8对ATAAD患者术后ALI的预测价值。结果术后共发生ALI 45例(33.33%),ALI组血浆S100A4、S100A8水平高于非ALI组(P<0.05)。年龄偏大、胸腔积液、高水平S100A4、高水平S100A8是ATAAD患者术后发生ALI的危险因素(P<0.05)。术前血浆S100A4、S100A8预测ATAAD患者术后ALI的曲线下面积分别为0.822、0.833,联合预测的曲线下面积为0.935,高于单独指标预测(P<0.05)。结论ATAAD术前血浆S100A4、S100A8水平升高与术后ALI风险发生有关,联合S100A4、S100A8可预测ATAAD患者术后ALI发生风险。
Objective To investigate the relationship between postoperative plasma levels of S100 calcium-binding protein A4(S100A4)and A8(S100A8)and the development of acute lung injury(ALI)in patients with acute Stanford type A aortic dissection(ATAAD).Methods This retrospective study enrolled 135 consecutive ATAAD patients who underwent surgical treatment at our cardiovascular surgery department between January 2018 and June 2023.All patients underwent surgical treatment and the levels of plasma S100A4 and S100A8 were detected before operation,and the occurrence of ALI was recorded after operation.The factors affecting postoperative ALI in ATAAD patients were analyzed by multivariate Logistic regression analysis,and the predictive value of plasma S100A4 and S100A8 on postoperative ALI in ATAAD patients was analyzed by receiver operating characteristic(ROC)curve.Results Postoperative ALI occurred in 45 patients(33.33%).The ALI group demonstrated significantly higher preoperative levels of both S100A4 and S100A8 compared to the non-ALI group(P<0.05).Older age,pleural effusion,high level of S100A4 and high level of S100A8 were risk factors for ALI after ATAAD(P<0.05).The area under the curve of preoperative plasma S100A4 and S100A8 in predicting postoperative ALI in ATAAD patients was 0.822 and 0.833 respectively.The area under the curve of combined prediction was 0.935,which was higher than that of single index prediction(P<0.05).Conclusion The increase of plasma S100A4 and S100A8 levels before ATAAD is related to the risk of postoperative ALI,and the combination of S100A4 and S100A8 can predict the risk of postoperative ALI in ATAAD patients.
作者
蒋礼
刘夏
Jiang Li;Liu Xia(Department of Intensive Care Medicine,Chengdu Third People's Hospital,Chengdu,Sichuan 610031,China)
出处
《四川医学》
2025年第8期924-929,共6页
Sichuan Medical Journal
