脓毒症并发急性呼吸窘迫综合征患者血清血管内皮钙黏蛋白、血管生成素2表达及与预后相关性研究  

Expression of serum vascular endothelial cadherin and angiopoietin 2 in sepsis patients complicated with acute respiratory distress syndrome and their correlation with prognosis

作　　者：张瑜 王娟[2] ZHANG Yu;WANG Juan(Department of Reproductive Medicine,Xi’an People’s Hospital,Xi’an 710004,China)

机构地区：[1]西安市人民医院西安市第四医院生殖医学科,陕西西安710004 [2]西安市儿童医院检验科,陕西西安710003

出　　处：《陕西医学杂志》2022年第2期176-179,190,共5页Shaanxi Medical Journal

基　　金：陕西省自然科学基础研究计划项目(2020JQ-927)。

摘　　要：目的:探讨脓毒症并发急性呼吸窘迫综合征患者血清血管内皮钙黏蛋白(VE-Cad)、血管生成素2(Ang-2)表达情况及与预后的相关性。方法:选取85例脓毒症并发急性呼吸窘迫综合征患者作为研究对象,根据动脉血氧分压(PaO_(2))/吸入氧浓度(FiO_(2))将患者分为重度组39例、中度组26例、轻度组20例,分析患者序贯器官功能衰竭(SOFA)评分、肺损伤(LIS)评分、急性生理和慢性健康状况评分Ⅱ(APACHEⅡ)及血清VE-Cad、Ang-2水平。并将85例患者中院内死亡的28例患者分为死亡组,剩余57例患者分为存活组,对比两组患者性别、年龄、感染部位、病原学、SOFA、LIS、APACHEⅡ、PaO_(2)/FiO_(2)、血清白蛋白(ALB)、重症监护室(ICU)住院时间、机械通气时间、VE-Cad、Ang-2表达情况,采用Logistic回归分析VE-Cad、Ang-2对脓毒症并发急性呼吸窘迫综合征的预后预测价值,采用受试者工作特征(ROC)曲线分析VE-Cad、Ang-2对脓毒症并发急性呼吸窘迫综合征患者的预后诊断价值。结果:三组患者SOFA、LIS、APACHEⅡ评分与血清VE-Cad、Ang-2水平对比差异有统计学意义(均P<0.05),重度组明显高于中度组与轻度组(均P<0.05);死亡组与存活组患者性别、年龄、感染部位、病原学、ICU住院时间对比无统计学差异(均P>0.05),死亡组与存活组患者SOFA、LIS、APACHEⅡ评分、PaO_(2)/FiO_(2)、ALB、机械通气时间、VE-Cad、Ang-2水平对比差异有统计学意义(均P<0.05);Logistic回归分析结果表明:APACHEⅡ评分升高、PaO_(2)/FiO_(2)降低、VE-Cad升高为脓毒症并发急性呼吸窘迫综合征预后独立影响因素(P<0.05);通过ROC曲线分析结果显示:VE-Cad、Ang-2两者联合的特异度与敏感度明显优于单一VE-Cad、Ang-2检验(P<0.05)。结论:脓毒症并发急性呼吸窘迫综合征患者血清VE-Cad、Ang-2与SOFA、LIS、APACHEⅡ评分相同,均随患者病情严重程度而升高,且血清VE-Cad水平对于脓毒症并发急性呼吸Objective:To investigate the expression of serum vascular endothelial cadherin(VE-Cad)and angiopoietin 2(Ang-2)in sepsis patients complicated with acute respiratory distress syndrome and their correlation with prognosis.Methods:A total of 85 sepsis patients complicated with acute respiratory distress syndrome were selected as the research objects.The patients were divided into severe group(39 cases),moderate group(26 cases)and mild group(20 cases)according to arterial oxygen partial pressure(PaO_(2))/fraction of inspiration O_(2)(FiO_(2)).The patients’SOFA score,LIS score,APACHEⅡscore,serum VE-Cad and Ang-2 levels were analyzed.The 28 patients who died in hospital in 85 patients were divided into the death group,and the remaining 57 patients were divided into the survival group,and the gender,age,infection site,etiology,SOFA score,LIS score,APACHEⅡscore,PaO_(2)/FiO_(2),ALB,ICU hospitalization time,mechanical ventilation time,VE-Cad and Ang-2 expression levels were compared between two groups.Logistic regression analysis was used to analyze the prognostic value of VE-Cad and Ang-2 in sepsis complicated with acute respiratory distress syndrome.The ROC curve analysis was used to analyze the prognostic diagnostic value of VE-Cad and Ang-2 in patients with sepsis complicated with acute respiratory distress syndrome.Results:The SOFA,LIS,APACHEⅡscores and serum VE-Cad and Ang-2 levels of the three groups were significantly different,and the severe group was significantly higher than the moderate group and the mild group(all P<0.05).There was no significant difference in gender,age,infection site,etiology and ICU hospitalization time between the death group and the survival group(all P>0.05).There was significant difference in SOFA,LIS,APACHEⅡscores,PaO_(2)/FiO_(2),ALB,mechanical ventilation time,VE-Cad and Ang-2 levels between the death group and the survival group(all P<0.05).Logistic regression analysis showed that the increase of APACHEⅡscore,the decrease of PaO_(2)/FiO_(2)and the increase of VE-Cad were

关 键 词：脓毒症 急性呼吸窘迫综合征 血管内皮钙黏蛋白 血管生成素2 预后 感染部位 

分 类 号：R595.5[医药卫生—内科学]