急性呼吸窘迫综合征患者呼出气冷凝液中白细胞介素-8、克拉拉细胞蛋白16、细胞间黏附分子-1检测的临床意义  

Clinical significance of interleukin-8, Clara cell protein 16 and intercellular adhesion molecule-1 in exhaled breath condensate in acute respiratory distress syndrome

作　　者：周亚清 濮尊国 刘爱明 丁宏胜 ZHOU Yaqing;PU Zunguo;LIU Aiming;DING Hongsheng(Department of Critical Care Medicine,Hai'an Hospital,Nantong University,Nantong,Jiangsu 226600,P.R.China)

机构地区：[1]南通大学附属海安医院重症医学科,江苏南通226600

出　　处：《中国呼吸与危重监护杂志》2021年第12期857-861,共5页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：江苏省南通市科技局基金(MSZ19001)。

摘　　要：目的监测急性呼吸窘迫综合征(ARDS)患者呼出气冷凝液(EBC)和血清中白细胞介素-8(IL-8)、克拉拉细胞蛋白16(CC16)、细胞间黏附分子-1(ICAM-1)的浓度,探讨其临床价值。方法选择45例ARDS患者为研究组,根据柏林诊断标准分为轻度组、中度组、重度组,同时选择45例健康人为对照组,检测各组患者EBC和血清中IL-8、CC16、ICAM-1的含量。结果与对照组相比,ARDS组血清和EBC中IL-8、CC16、ICAM-1均显著增高(P<0.05)。随着ARDS严重程度的加重,患者血清及EBC中IL-8水平有升高趋势,但差异无统计学意义(P>0.05)。与轻度、中度组相比,重度组患者血清及EBC中CC16含量显著升高(P<0.05)。患者入院第1天时,重度组、中度组血清ICAM-1含量与轻度组比较有差异(P<0.05),三组患者EBC中ICAM-1含量两两比较均有差异(均P<0.05)。入院第5天时,重度组EBC中ICAM-1含量与轻度组、中度组相比显著升高(均P<0.05)。不论ARDS严重程度的高低,患者入院第1天和第5天的血清和EBC中IL-8、CC16含量无显著性差异(均P>0.05);轻度组血清除外,患者入院第1天和第5天的血清和EBC中ICAM-1水平均有显著性差异(均P<0.05)。ARDS患者死亡组在血清和EBC中ICAM-1含量均显著高于存活组(均P<0.05)。结论 EBC和血清中IL-8、CC16、ICAM-1的检测,对于ARDS的诊断及预后评估有一定的参考价值。Objective To explore clinical significance of interleukin-8(IL-8), clarada protein 16(CC16), and intercellular adhesion molecule-1(ICAM-1) in exhaled breath condensate(EBC) and serum samples collected from patients with acute respiratory distress syndrome(ARDS). Methods A total of 45 ARDS patients were assigned into a mild ARDS group(n=20), a moderate ARDS group(n=15) and a severe ARDS group(n=10) based on the Berlin definition. During the same study period, 45 healthy subjects were recruited as control. Serum and EBC levels of IL-8,CC16 and ICAM-1 were detected on the first and fifth day of admission. Results Compared with the control group,serum and EBC IL-8, CC16 and ICAM-1 were significantly higher in the ARDS groups(P<0.05). Serum and EBC IL-8 levels increased with the severity of ARDS, whereas no significant difference was detected between the three groups(P>0.05). Compared with the mild group and the moderate group, serum and EBC CC16 levels were significantly higher in the severe ARDS group. At the first day after admission, serum ICAM-1 was higher in the severe and moderate ARDS groups than that in the mild ARDS group(P<0.05). Meanwhile, EBC ICAM-1 was significantly different between the three groups(P<0.05). At the fifth day after admission, different EBC ICAM-1 was identified between the severe ARDS group and the other two groups(P<0.05). Regardless of ARDS severity, there were no significant differences in serum and EBC IL-8 and CC16 levels at the first and fifth days after admission(P>0.05). However, serum and EBC ICAM-1 at the first and fifth days showed significant difference(except in the mild ARDS group)(P<0.05). The levels of ICAM-1 in serum and EBC of death group were significantly higher than those of survival group(P<0.05). Conclusion Serum and EBC IL-8,CC16 and ICAM-1 are of significance in diagnosis and prognosis evaluation of ARDS.

关 键 词：急性呼吸窘迫综合征 呼出气冷凝液 白细胞介素-8 克拉拉细胞蛋白16 细胞间黏附分子-1 

分 类 号：R563.8[医药卫生—呼吸系统]