ICAM-1对脓毒症所致急性肺损伤与呼吸窘迫综合征的临床诊断和预后评估作用  

Clinical diagnosis and prognosis of acute lung injury and respiratory distress syndrome caused by sepsis with icam-1

作　　者：王晓林[1] 李静 黄艳丽 WANG Xiao-lin;LI Jing;HUANG Yan-li(Department of Critical Medicine,Qinhuangdao First Hospital,Qinhuangdao 066000,China;Pharmacy,Qinhuangdao First Hospital,Qinhuangdao First Hospital,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市第一医院内科ICU,河北秦皇岛066000 [2]秦皇岛市第一医院药房,河北秦皇岛066000

出　　处：《中国实验诊断学》2020年第5期759-762,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨ICAM-1对脓毒症所致急性肺损伤与呼吸窘迫综合征的临床诊断和预后评估作用。方法选取2018年2月-2019年9月我院收治的脓毒症患者76例,根据其症状表现将其分为单纯脓毒症组43例,合并急性肺损伤组21例,以及同时合并急性肺损伤、呼吸窘迫综合征组12例,分析其ICAM-1水平对于疾病诊断以及预后评估的价值。结果同时合并肺损伤与呼吸窘迫综合征组患者ICAM-1水平以及SOFA评分均高于脓毒症组以及合并肺损伤组(P<0.05),而合并肺损伤组患者ICAM-1水平以及SOFA评分均高于脓毒症组(P<0.05);同时合并肺损伤与呼吸窘迫综合征组患者VCAM-1、TNF-α以及NF-кB水平均高于脓毒症组以及合并肺损伤组(P<0.05),合并肺损伤组患者VCAM-1、TNF-α以及NF-кB水平高于脓毒症组(P<0.05);同时合并肺损伤与呼吸窘迫综合征组患者MPO高于脓毒症组以及合并肺损伤组,SOD低于脓毒症组以及合并肺损伤组(P<0.05),合并肺损伤组患者MPO高于脓毒症组,SOD低于脓毒症组(P<0.05);ICAM-1高水平组患者好转率低于ICAM-1低水平组(P<0.05)。结论脓毒症同时合并急性肺损伤以及合并呼吸窘迫综合征会明显升高患者ICAM-1水平,且高水平ICAM-1会导致患者发生预后不良情况,可以通过对ICAM-1水平进行检测的方式对患者疾病的诊断以及预后评估,为提高判断准确性可配合进行氧化应激因子以及炎症反应因子检测。Objective To evaluate the clinical diagnosis and prognosis of acute lung injury and respiratory distress syndrome caused by sepsis with icam-1.Methods Selection in February 2018-September 2019our hospital 76cases of patients with sepsis,according to its symptom will be divided into pure sepsis group 43cases,21cases complicating acute lung injury group,and at the same time with acute lung injury,respiratory distress syndrome group of 12cases,analyze the ICAM-1level for disease diagnosis and prognosis evaluation of value.Results The level of icam-1and SOFA score of patients in the combined lung injury and respiratory distress syndrome group were higher than those in the sepsis group and the combined lung injury group(P<0.05).The level of icam-1and SOFA score of patients in the combined lung injury group were higher than those in the sepsis group(P<0.05).With pulmonary injury patients with respiratory distress syndrome group,TNF alpha and VCAM-1NF-seem B level were higher than in sepsis group and combined lung injury group(P<0.05),with pulmonary injury patients,TNF alpha and VCAM-1NF-seem levels were higher than in sepsis group B(P<0.05);MPO of patients in the combined lung injury and respiratory distress syndrome group was higher than that in the sepsis group and the combined lung injury group,while SOD was lower than that in the sepsis group and the combined lung injury group(P<0.05).The improvement rate of patients in the highlevel icam-1group was lower than that in the low-level icam-1group(P<0.05).Conclusion Sepsis acute lung injury and the combining patients with respiratory distress syndrome can markedly increase ICAM-1level,and can lead to high level ICAM-1in patients with poor prognosis,detect the ICAM-1level can be achieved by the way to evaluate the diagnosis and prognosis of patients with diseases,in order to improve accuracy factor can cooperate to oxidative stress and inflammation factor test.

关 键 词：脓毒症 呼吸窘迫综合征 急性肺损伤 预后评估 临床诊断 

分 类 号：R631[医药卫生—外科学]