血清涎液化糖链抗原-6对机械通气输血患者发生急性肺损伤的预测价值  

Predictive value of serum KL-6 for acute lung injury in patients with mechanical ventilation and transfusion

作　　者：徐健[1] 李先莉 杨丽华[3] 吴林伯 XU Jian;LI Xianli;YANG Lihua;WU Linbo(Department of Blood Transfusion,Dazhou Central Hospital,Dazhou 635000,China;不详)

机构地区：[1]达州市中心医院输血科,四川达州635000 [2]达州市中心医院医学检验科 [3]达州市中心医院血液科

出　　处：《山东医药》2021年第22期6-9,共4页Shandong Medical Journal

基　　金：四川省卫生和计划生育委员会科研课题(17P0137)。

摘　　要：目的分析血清涎液化糖链抗原-6(KL-6)水平对机械通气输血患者并发急性肺损伤(ALI)的预测价值。方法选取机械通气并行输血治疗的患者412例,按输血后6 h内是否发生ALI分为ALI组(142例)和非ALI组(270例),对比两组输血前后血清KL-6和ALI临床相关指标水平,使用Pearson相关分析KL-6水平与ALI临床相关指标的相关性,使用受试者工作特征(ROC)曲线评估血清KL-6对ALI的预测价值。结果ALI组输血后的血清KL-6、肺损伤评分(Murray评分)、呼吸机平台压、呼吸机峰压高于输血前和非ALI组输血后,而氧合指数低于输血前和非ALI组输血后(P均<0.05)。与输血前相比,非ALI组输血后血清KL-6、Murray评分、呼吸机平台压、呼吸机峰压、氧合指数及B型钠尿肽(BNP)差异无统计学意义(P均>0.05)。Pearson相关分析显示,ALI组血清KL-6水平与Murray评分呈正相关(r=7.440,P<0.001),与氧合指数呈负相关(r=-0.771,P<0.001)。KL-6预测ALI的ROC曲线下面积为0.931(P<0.001),最佳截断值为374.85 U/mL,准确度为0.838,灵敏度为88.41%,特异度为95.42%。结论血清KL-6对机械通气输血患者发生ALI的预测价值较高,且与病情严重程度相关,有助于ALI的预测及病情评估。Objective To analyze the predictive value of serum kerbs von den lungeren 6(KL-6)level for acute lung injury(ALI)in patients after mechanical ventilation and blood transfusion.Methods A total of 412 patients under‐going mechanical ventilation and blood transfusion were selected as the study subjects.According to whether ALI occurred within 6 h after blood transfusion,they were divided into the ALI group(142 cases)and the non-ALI group(270 cases).We compared the KL-6 and ALI-related indicators before and after blood transfusion in the two groups,the correlation be‐tween KL-6 level and ALI-related indicators was analyzed by Pearson correlation analysis,and the predictive value of KL-6 for ALI was evaluated by recerver operating characteristic(ROC)curve.Results KL-6,lung injury score(Murray score),ventilator platform pressure and ventilator peak pressure in the ALI group were significantly higher than those be‐fore blood transfusion and the non-ALI group after blood transfusion,while the oxygenation index was significantly lower than those before blood transfusion and non-ALI group after blood transfusion(all P<0.05).KL-6,Murray score,ventila‐tor platform pressure,ventilator peak pressure,oxygenation index,and B-type natriuretic peptide(BNP)in the non-ALI group after blood transfusion showed no significant changes compared with those before blood transfusion(all P>0.05).Pearson correlation analysis showed that KL-6 level in the ALI group was positively correlated with Murray score(r=7.440,P<0.001)and was negatively correlated with oxygenation index(r=-0.771,P<0.001).The area under the ROC curve of KL-6 in predicting ALI was 0.931(P<0.001),the best cut-off value was 374.85 U/mL,the accuracy was 0.838,the sensitivity was 88.41%,and the specificity was 95.42%.Conclusion Serum KL-6 has a high predictive value for ALI in patients with mechanical ventilation and blood transfusion,and is significantly correlated with the severity of the disease,which is helpful for the diagnosis and evaluation of ALI.

关 键 词：急性肺损伤 输血 涎液化糖链抗原-6 预测价值 

分 类 号：R563[医药卫生—呼吸系统]