血清可溶性白细胞分化抗原14、脂多糖结合蛋白水平变化对ARDS患者疾病转归的影响  

Effects of Serum Soluble Leukocyte Differentiation Antigen14 and Lipopolysaccharide-Binding Protein Levels onDisease Outcomes in ARDS Patients

作　　者：杨闪闪[1] YANG Shan-shan(Department of Respiratory Medicine,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第五附属医院呼吸内科,郑州450052

出　　处：《实用临床医学（江西）》2023年第2期9-13,共5页Practical Clinical Medicine

摘　　要：目的研究血清可溶性白细胞分化抗原14(sCD14)、脂多糖结合蛋白(LBP)水平变化与急性呼吸窘迫综合征(ARDS)患者疾病转归的相关性。方法选取109例ARDS患者,按患者28 d预后结局分为生存组(n=62)和死亡组(n=47)。比较2组患者临床资料,包括性别、年龄、体重指数、原发病(外科手术、创伤、胰腺炎、肺部感染)情况、既往吸烟史、既往饮酒史、合并症(高血压、冠心病、糖尿病)情况、降钙素原水平等;比较2组入院时、入院7 d后血清sCD14、LBP水平及急性生理学及慢性健康状况评分Ⅱ(APACHEⅡ评分);采用Logistic多因素分析影响ARDS患者疾病转归的影响因素;分析血清sCD14和LBP水平与APACHEⅡ评分的相关性(Pearson相关分析)及对ARDS患者疾病转归的预测效能(ROC曲线)。结果2组合并疾病类型、既往饮酒史对比差异有统计学意义(P<0.05,P<0.01)。入院时、入院7 d后死亡组血清sCD14、LBP水平及APACHEⅡ评分均高于生存组(均P<0.001)。ARDS患者APACHEⅡ评分与血清sCD14和LBP水平均呈正相关(r=0.575,r=0.721;均P<0.05)。Logistic多因素分析显示,血清sCD14≥42.26μg·L-1(OR=3.936,95%CI:1.482~10.452)、血清LBP≥95.61μg·mL-1(OR=3.028,95%CI:1.457~6.293)是影响ARDS患者疾病转归的独立相关因素(均P<0.05);ROC曲线分析结果显示,血清sCD14联合LBP预测ARDS患者疾病转归的效能高于血清sCD14、LBP单独预测效能(均P<0.05)。结论血清sCD14和LBP水平是影响ARDS患者疾病转归的相关因素,血清sCD14联合LBP检测有利于ARDS早期病情诊断和预后评估。Objective To investigate the correlation between serum soluble leukocyte differentiation antigen 14(sCD14)and lipopolysaccharide-binding protein(LBP)levels and disease outcomes in patients with acute respiratory distress syndrome(ARDS).Methods A total of 109 patients with ARDS were divided into survival group(n=62)and death group(n=47)according to the 28-day prognosis.Clinical data including gender,age,body mass index and primary diseases(surgery,trauma,pancreatitis and lung infection),history of smoking,history of alcohol consumption,complications(hypertension,coronary heart disease and diabetes),and procalcitonin levels were compared between the two groups.Serum sCD14 and LBP levels and Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)scores were measured at admission and 7 days after admission.The factors influencing disease outcomes were analyzed using multivariate logistic analysis.The correlation between serum sCD14 and LBP levels and APACHEⅡscores was analyze using Pearson correlation,and their predictive efficacies for disease outcomes were analyzed using the ROC curve.Results There were significant differences in disease type and previous drinking history between the two groups(P<0.05 and P<0.01,respectively).Serum sCD14 and LBP levels and APACHEⅡscores in the death group were higher than those in the survival group at admission and 7 days after admission(P<0.05).The APACHEⅡscores were positively correlated with serum sCD14 and LBP levels in ARDS patients(r=0.575 and 0.721,respectively;P<0.05).Logistic multivariate analysis showed that serum sCD14≥42.26μg·L-1(OR=3.936,95%CI:1.482-10.452)and LBP≥95.61μg·mL-1(OR=3.028,95%CI:1.457-6.293)were independent factors affecting the outcomes of ARDS patients(P<0.05).ROC curve analysis indicated that the efficacy of combined sCD14 and LBP was higher than that of sCD14 or LBP alone in predicting the outcomes of ARDS patients(P<0.05).Conclusion Serum sCD14 and LBP levels are factors affecting the outcomes of ARDS patients,and their combined de

关 键 词：急性呼吸窘迫综合征 可溶性白细胞分化抗原14 脂多糖结合蛋白 

分 类 号：R563.8[医药卫生—呼吸系统]