血清HIF-1α,VEGF,Flt-1检测在急性呼吸窘迫综合征患者中的临床意义及预后评估价值  

Clinical significance and prognostic values of serum HIF-1α, VEGF,and Flt-1 in patients with acute respiratory distress syndrome

作　　者：韩春艳 赵君焱 HAN Chunyan;ZHAO Junyan(Department of Critical Care Medicine,Huai'an First Hospital Affiliated to Nanjing Mrdical University,Huai'an Jiangsu 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院重症医学科,江苏淮安223300

出　　处：《中国急救复苏与灾害医学杂志》2022年第10期1331-1335,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：江苏省自然科学基金青年基金(编号:BK20160231)。

摘　　要：目的 探讨血清缺氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)、Fms样酪氨酸激酶-1(Flt-1)检测在急性呼吸窘迫综合征(ARDS)患者中的临床意义及预后评估价值。方法 选取2018年4月—2021年4月南京医科大学附属淮安第一医院收治的121例ARDS患者为研究对象,入院治疗后随访28 d。对比ARDS不同病情严重程度患者血清HIF-1α、VEGF、Flt-1情况,统计28 d生存结局,分析影响ARDS患者预后的影响因素,分析HIF-1α、VEGF、Flt-1预测ARDS患者预后的价值。结果 轻度病情者血清HIF-1α、VEGF、Flt-1水平均低于中度病情者、重度病情者(P<0.05),中度病情者血清HIF-1α、VEGF、Flt-1水平均低于重度病情者(P<0.05)。121例ARDS患者中23例死亡,剩余98例存活。Logistic多因素回归分析显示重症病情、HIF-1α、VEGF、Flt-1是影响ARDS患者预后的独立因素(P<0.05)。ROC曲线显示HIF-1α、VEGF、Flt-1及三者联合预测ARDS患者预后的AUC分别为0.754、0.774、0.776、0.888。结论 ARDS患者预后不良风险高,HIF-1α、VEGF、Flt-1与ARDS患者病情、预后有关,三者联合预测ARDS患者预后效能良好。ObjectiveTo explore the clinical significance and prognostic values of serum hypoxia-inducible factor-1α(HIF-1α),vascular endothelial growth factor(VEGF),and Fms-like tyrosine kinase-1(Flt-1)in patients with acute respiratory distress syndrome(ARDS).MethodsA total of 121 ARDS patients were admitted,underwent conventional treatment,divided into 3 groups of severity according to the levels of oxygenation index(OI)and positive end expiration pressure(PEEP):mild disease group(n=36),moderate disease group(n=52),and severe disease group(n=32),and followed up for 28 days.Peripheral fasting venous blood samples were collected after admission to detect the levels of serum HIF-1α,VEGF,Flt-1 by ELISA.Related clinical data were collected.Logistic regression was used to analyze the factors influencing the prognosis of the ARDS patients.Receiver operating characteristic curve was used to access the predictive values of different factors.ResultsThe levels of serum HIF-1α,VEGF,and Flt-1 in the patients with mild disease were significantly lower than those in the moderate disease and severe disease groups(all P<0.05);and the levels of serum HIF-1α,VEGF,and Flt-1 in the patients with moderate disease were all significantly lower than those in the patients with severe disease(all P<0.05).The follow-up showed that 23 of the patients died and 98 survived.The percentage of severe illness,APACHEⅡscore,SOFA score,OI level,serum levels of creatinine HIF-1α,VEGF,and Flt-1 of the death group were all significantly higher than those of the survival group(all P<0.05).Logistic multivariate regression analysis showed that severity of illness,HIF-1α,VEGF,and Flt-1 were independent factors affecting the prognosis of ARDS patients(all P<0.05).The ROC curve analysis showed that the AUC of HIF-1α,VEGF,Flt-1 and the combination of the three to predict the prognosis of ARDS patients were 0.754,0.774,0.776,and 0.888 respectively.ConclusionARDS patients have a high risk of poor prognosis.HIF-1α,VEGF and Flt-1 are related to the condition and

关 键 词：急性呼吸窘迫综合征 缺氧诱导因子-1Α 血管内皮生长因子 Fms样酪氨酸激酶-1 预后 

分 类 号：R563[医药卫生—呼吸系统]