血管内皮生长因子、降钙素原、白细胞介素-18对急性创伤病人呼吸衰竭的预测价值  

Predictive value of serum PCT,VEGF and IL-18 in respiratory failure in patients with acute trauma

作　　者：郑刚[1] 李刘英[1] 陈树民[1] ZHENG Gang;LI Liuying;CHEN Shumin(Department of Respiratory and Critical Care Medicine,The First People's Hospital of Zigong,Zigong,Sichuan 643000,China)

机构地区：[1]自贡市第一人民医院呼吸与危重症医学科,四川自贡643000

出　　处：《安徽医药》2022年第5期974-976,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的观察急性创伤合并呼吸衰竭病人的血管内皮生长因子(VEGF)、降钙素原(PCT)、白细胞介素-18(IL-18)水平,探讨三者对急性创伤病人呼吸衰竭的预测价值。方法回顾性分析2018年1月至2019年12月于自贡市第一人民医院住院治疗的急性创伤合并呼吸衰竭病人70例的临床资料,根据其转归分为好转组(60例)和死亡组(10例)。比较好转组和死亡组病人VEGF、PCT、IL-18、血气指标、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分的差异,分析急性创伤病人PCT、VEGF、IL-18指标与血气指标、APACHEⅡ评分的相关性。结果好转组VEGF[(126.36±15.78)ng/L比(138.27±17.64)ng/L]、PCT[(3.22±0.78)mg/L比(4.24±1.30)mg/L]、IL-18[(136.74±23.09)ng/L比(195.64±36.13)ng/L]水平均低于死亡组,差异有统计学意义(P<0.05);好转组病人氧饱和度(SO_(2))[(56.28±6.39)%比(41.64±8.15)%]、氧分压(PaO_(2))[(99.02±0.28)mmHg比(95.36±0.28)mmHg]、氧合指数(PaO_(2)/FiO_(2))[(215.47±37.53)比(176.47±36.25)]水平均高于死亡组、死亡组病人APACHEⅡ评分高于好转组[(19.45±2.42)分比(22.00±2.45)分],差异有统计学意义(P<0.05);急性创伤病人的PCT、VEGF、IL-18水平与SO_(2)、PaO_(2)、PaO_(2)/FiO_(2)水平呈负相关,与APACHEⅡ评分呈正相关,差异有统计学意义(P<0.05)。结论急性创伤合并呼吸衰竭病人的PCT、VEGF、IL-18水平较高,PCT、VEGF、IL-18可反映急性创伤并呼吸衰竭病人的病情程度,三者表达水平越高,可能提示呼吸功能损伤越严重,呼吸衰竭越明显,病情越危重,预后越差。Objective To observe the levels of PCT,VEGF and IL-18 in patients with acute trauma and respiratory failure,and to analyze the predictive value of the three for respiratory failure in patients with acute trauma.Methods The clinical data of 70 patients with acute trauma and respiratory failure who were hospitalized in Zigong First People's Hospital from January 2018 to December 2019 were analyzed retrospectively.According to their outcomes,they were assigned into two groups:improvement group(60 cases)and death group(10 cases).The differences of vascular endothelial growth factor(VEGF),procalcitonin(PCT),interleukin-18(IL-18),blood gas index and APACHEⅡscore between the improved group and the dead group were compared,and the correlation of PCT,VEGF,IL-18 index with blood gas index and APACHEⅡscore in the patients with acute trauma were analyzed.Results The levels of VEGF[(126.36±15.78)ng/L vs.(138.27±17.64)ng/L],PCT[(3.22±0.78)mg/L vs.(4.24±1.30)mg/L]and IL-18[(136.74±23.09)ng/L vs.(195.64±36.13)ng/L]in the improvement group were lower than those in the death group,with statistical significance(P<0.05);the levels of SO_(2)[(56.28±6.39)%vs.(41.64±8.15)%],PaO_(2)[(99.02±0.28)mmHg vs.(95.36±0.28)mmHg]and PaO_(2)/FiO_(2)[(215.47±37.53)vs.(176.47±36.25)]in the improvement group were higher than those in the death group,and the APACHEⅡscore in the death group was higher than that in the improvement group[(19.45±2.42)points vs.(22.00±2.45)points],the difference was statistically significant(P<0.05).The PCT,VEGF and IL-18 levels in patients with acute trauma were negatively correlated with SO_(2),PaO_(2) and PaO_(2)/FiO_(2) levels,and positively correlated with APACHEⅡscores,the difference was statistically significant(P<0.05).Conclusion PCT,VEGF and IL-18 levels are higher in patients with acute trauma and respiratory failure.PCT,VEGF and IL-18 can reflect the condition of patients with acute trauma and respiratory failure.The higher the expression level of PCT,VEGF and IL-18 is,the more serious the

关 键 词：创伤和损伤 呼吸衰竭 降钙素原 血管内皮生长因子 白细胞介素-18 

分 类 号：R641[医药卫生—外科学] R563.8[医药卫生—临床医学]