外周血MIF与脓毒症患者病情严重程度的相关性及预测ARDS发生的价值  

Study on Relationship of Peripheral Blood MIF with Severity of Sepsis for Predictive Value of ARDS

作　　者：卞茂成 钟斐[1] 万健[1] BIAN Mao-cheng;ZHONG Fei;WAN Jian(Department of Emergency and Critical Medicine,Pudong New Area People's Hospital,Shanghai 210299)

机构地区：[1]上海市浦东新区人民医院急诊与重症医学科,上海210299

出　　处：《医学临床研究》2023年第2期176-179,共4页Journal of Clinical Research

基　　金：上海市医学重点专科建设项目(ZK2019C08)。

摘　　要：【目的】探讨外周血巨噬细胞迁移抑制因子(MIF)与脓毒症患者病情严重程度的相关性及预测急性呼吸窘迫综合征(ARDS)发生的价值。【方法】收集本院收治的95例脓毒症患者的基本资料及治疗前生化指标,治疗后随访2周。分析并比较不同病情严重程度脓毒症患者外周血MIF水平及急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)、序贯器官衰竭评估评分(SOFA)情况,分析影响脓毒症患者并发ARDS的因素,分析外周血MIF预测脓毒症患者并发ARDS的价值。【结果】脓毒症休克组患者MIF水平及APACHEⅡ、SOFA均高于脓毒症组(P<0.05)。Pearson相关性分析显示:脓毒症患者MIF水平与APACHEⅡ、SOFA均呈正相关(P<0.05)。Logistic多因素回归分析显示:APACHEⅡ评分、MIF、氧合指数是影响脓毒症患者并发ARDS的独立因素(P<0.05)。受试者工作特征(ROC)曲线分析显示,外周血MIF预测脓毒症患者并发ARDS的灵敏度、特异度、曲线下面积(AUC)分别为71.43%、79.66%、0.778。【结论】脓毒症患者外周血MIF水平与其病情严重程度、并发ARDS有关,MIF预测脓毒症患者并发ARDS效能良好。【Objective】To explore the relationship of peripheral blood macrophage migration inhibitory factor(MIF)with the severity of sepsis to predict complication of acute respiratory distress syndrome(ARDS).【Methods】A total of 95 patients with sepsis admitted to the hospital were selected.The basic data of all patients and biochemical indicators before treatment were collected.Patients were followed up for 2 weeks after treatment.Peripheral blood MIF,acute physiology and chronic health scoreⅡ(APACHEⅡ),and sequential organ failure assessment(SOFA)scores of sepsis patients with different severity levels were analyzed.Factors affecting ARDS in patients with sepsis were analyzed.And the value of peripheral blood MIF in predicting ARDS in patients with sepsis was analyzed as well.【Results】The scores of MIF,APACHEⅡand SOFA in the septic shock group were higher than those in the sepsis group(P<0.05).Pearson correlation analysis showed that the level of MIF in patients with sepsis was positively correlated with APACHEⅡscore and SOFA score(P<0.05).Logistic multivariate regression analysis showed that APACHEⅡscore,MIF,and oxygenation index were independent factors that affected patients with sepsis complicated by ARDS(P<0.05).ROC curve analysis showed that the sensitivity,specificity,and area under AUC of peripheral blood MIF in predicting sepsis patients with ARDS were 71.43%,79.66%,and 0.778,respectively.【Conclusion】The level of peripheral blood MIF in patients with sepsis is related to the severity of the disease and ARDS complication.MIF is effective in predicting ARDS in patients with sepsis.

关 键 词：脓毒症 巨噬细胞游走抑制因子/血液 呼吸窘迫综合征 病人病情 

分 类 号：R631.1[医药卫生—外科学]