外周血HMGB1、RAGE联合qSOFA评分在急性呼吸衰竭并发心肌损伤评估中的应用价值  

Application Value of Peripheral Blood HMGB1,RAGE and qSOFA Score in the Evaluation of Acute Respiratory Failure Complicated with Myocardial Injury

作　　者：王小平 李杰 WANG Xiaoping;LI Jie(Xingshan County People's Hospital,Xingshan 443700,China;不详)

机构地区：[1]兴山县人民医院,湖北兴山443700 [2]湖北省第三人民医院

出　　处：《中外医学研究》2023年第23期78-82,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：湖北省卫生健康委科研项目(WJ2019M238)。

摘　　要：目的:探究外周血高迁移率族蛋白-1(high mobility group box protein 1,HMGB1)、糖基化终产物受体(receptor for advanced glycation endproducts,RAGE)和快速顺序器官功能衰竭评估(quick sequential organ failure assessment,qSOFA)评分在急性呼吸衰竭并发心肌损伤评估中的应用价值。方法:选择2020年1月-2022年12月就诊于兴山县人民医院的129例急性呼吸衰竭患者作为观察对象,根据患者是否并发心肌损伤将其分为心肌损伤组(n=43)和非心肌损伤组(n=86)。收集所有研究对象入组时的年龄、性别、体重指数等一般资料;评估受试者qSOFA评分,检测受试者外周血HMGB1和RAGE水平;logistic回归分析急性呼吸衰竭并发心肌损伤的影响因素;受试者工作特性曲线(receiver operator characteristic curve,ROC)分析HMGB1、RAGE联合qSOFA评分对急性呼吸衰竭并发心肌损伤的评估价值。结果:心肌损伤组一秒率[第1秒用力呼气容积(forced expiratory volume in one second,FEV1)/用力肺活量(forced vital capacity,FVC)%]和动脉血氧分压(arterial partial pressure of oxygen,PaO2)显著低于非心肌损伤组,动脉血二氧化碳分压(arterial carbon dioxide partial pressure,PaCO_(2))显著高于非心肌损伤组,差异有统计学意义(P<0.05);心肌损伤组外周血HMGB1、RAGE水平和q SOFA评分均显著高于非心肌损伤组,差异有统计学意义(P<0.05);logistic回归分析显示,HMGB1、RAGE水平和qSOFA评分升高均为急性呼吸衰竭患者并发心肌损伤的独立危险因素(P<0.05);ROC分析显示,HMGB1、RAGE水平、qSOFA评分联合检测ROC曲线下面积(AUC)明显高于各指标单独检测,差异有统计学意义(P<0.05)。结论:HMGB1、RAGE水平和qSOFA评分升高均为急性呼吸衰竭患者并发心肌损伤的独立危险因素;HMGB1、RAGE水平和qSOFA评分均可对急性呼吸衰竭患者心肌损伤的发生进行评估,且联合评估的价值更高。Objective:To explore the application value of peripheral blood high mobility group box protein 1(HMGB1),receptor for advanced glycation endproducts(RAGE)and quick sequential organ failure assessment(qSOFA)score in the evaluation of acute respiratory failure complicated with myocardial injury.Method:A total of 129 patients with acute respiratory failure who visited Xingshan County People's Hospital from January 2020 to December 2022 were selected as the observation objects.According to whether complicated with myocardial injury,they were divided into the myocardial injury group(n=43)and the non myocardial injury group(n=86).General information such as age,gender and body mass index of all research subjects at the time of enrollment were collected;the qSOFA scores of the subjects were evaluated and the levels of HMGB1 and RAGE in their peripheral blood were detected;logistic regression analysis was used to analyze the influencing factors of acute respiratory failure complicated with myocardial injury;the receiver operator characteristic curve(ROC)was used to analyze the value of HMGB1,RAGE combined with qSOFA score in the evaluation of acute respiratory failure complicated with myocardial injury.Result:The forced expiratory volume in one second(FEV1)/forced vital capacity(FVC)%and arterial partial pressure of oxygen(PaO_(2))levels in the myocardial injury group were significantly lower than those in the non myocardial injury group,while arterial carbon dioxide partial pressure(PaCO2)level was significantly higher than that in the non myocardial injury group,the differences were statistically significant(P<0.05).The peripheral blood HMGB1,RAGE levels,and qSOFA scores in the myocardial injury group were significantly higher than those in the non myocardial injury group,the differences were statistically significant(P<0.05).logistic regression analysis showed that elevated HMGB1,RAGE levels and qSOFA scores were independent risk factors for patients with acute respiratory failure complicated with myocardial injury(P<0

关 键 词：急性呼吸衰竭 心肌损伤 高迁移率族蛋白-1 糖基化终产物受体 快速顺序器官功能衰竭评估 

分 类 号：R563.8[医药卫生—呼吸系统] R542.2[医药卫生—内科学]