重症呼吸衰竭患者心肌损害与ET-1、IL-18、NO水平的关系  

Relationship between myocardial damage and the levels of serum ET-1,IL-18 and NO in patients with severe respiratory failure

作　　者：吴畏[1] 郭晓鹤[2] 杨飞云[1] 孔令宇[1] 牛丽丹[1] 石金河[1] WU Wei;GUO Xiaohe;YANG Feiyun;KONG Lingyu;NIU Lidan;SHI Jinhe(Department of EICU,the First Affiliated Hospital of Xinxiang Medical College,Weihui,Henan,China,453100;Department of Gastroenterology,the First Affiliated Hospital of Xinxiang Medical University,Weihui,Henan,China,453100)

机构地区：[1]新乡医学院第一附属医院EICU,河南卫辉453100 [2]新乡医学院第一附属医院消化内科,河南卫辉453100

出　　处：《分子诊断与治疗杂志》2021年第5期820-823,共4页Journal of Molecular Diagnostics and Therapy

基　　金：河南省医学科技攻关计划项目(201702129)。

摘　　要：目的分析重症呼吸衰竭患者心肌损害与内皮素-1(ET-1)、白细胞介素-18(IL-18)及内源性一氧化氮(NO)水平的关系。方法选取2017年4月至2020年4月本院收治的120例重症呼吸衰竭患者设为研究组,根据是否发生心肌损伤分为心肌损害组(n=37例)、非心肌损害组(n=83例),同时纳入同期本院接受健康体检结果正常者(共52例)作为对照组。记录血清ET-1、IL-18及NO水平,比较不同人群血清ET-1、IL-18及NO水平差异,采用多元Logistic回归分析影响重症呼吸衰竭患者发生心肌损害的危险因素,绘制ROC曲线分析ET-1、IL-18及NO水平对重症呼吸衰竭患者发生心肌损害的预测价值。结果研究组患者ET-1、IL-18及NO水平显著高于对照组,差异有统计学意义(P<0.05)。心肌损害组患者ET-1、IL-18及NO水平显著高于非心肌损害组,差异有统计学意义(P<0.05)。Logistic回归模型得出:ET-1、IL-18、NO异常升高为影响重症呼吸衰竭患者发生心肌损害的独立危险因素(P<0.05)。ROC曲线得出:ET-1曲线下面积为0.780,IL-18曲线下面积为0.688,NO曲线下面积为0.784,三者联合曲线下面积为0.938,以联合检测下面积值最大(P<0.05)。结论血清ET-1、IL-18及NO水平与重症呼吸衰竭患者心肌损害密切相关,临床工作者可通过加强监测这三项指标,评估疾病进展与预后情况。Objective To analyze the relationship between myocardial damage and endothelin-1(ET-1),interleukin-18(IL-18)and endogenous nitric oxide(NO)levels in patients with severe respiratory failure.Methods A total of 120 patients with severe respiratory failure admitted to this hospital from April2017 to April 2020 were selected as the study group.According to whether myocardial injury occurred or not,they were divided into the myocardial damage group(n=37 cases)and the non-myocardial damage group(n=83 cases).At the same time,patients with normal physical examination results in this hospital during the same period(52 cases in total)were included as the control group.The serum ET-1,IL-18 and NO levels were recorded,and the differences in serum ET-1,IL-18 and NO levels in different people were compared.Multivariate logistic regression was used to analyze the risk factors of myocardial damage in patients with severe respiratory failure,and ROC curve was drawn to analyze the value of ET-1,IL-18,and NO levels in predicting myocardial damage in patients with severe respiratory failure.Results The levels of ET-1,IL-18,and NO in the study group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The levels of ET-1,IL-18 and NO in the myocardial damage group were significantly higher than those in the non-myocardial damage group,and the differences were statistically significant(P<0.05).Logistic regression model showed that the abnormal increasing of ET-1,IL-18 and NO were independent risk factors affecting myocardial damage in patients with severe respiratory failure(P<0.05).The ROC curve shows that the area under the ET-1 curve is 0.780,the area under the IL-18 curve is 0.688,the area under the NO curve is 0.784,and the area under the three combined curve is 0.938,the area under the combined detection is the largest(P<0.05).Conclusion Serum ET-1,IL-18 and NO levels are closely related to myocardial damage in patients with severe respiratory failure.Clinicians can

关 键 词：重症呼吸衰竭 ET-1 IL-18 NO 心肌损害 

分 类 号：R563.8[医药卫生—呼吸系统]