血清NT-proBNP、HMGB1及sTREM-1水平在脓毒症急性肺损伤预后评估中的价值  

Evaluation value of serum NT-proBNP,HMGB1 and sTREM-1 in prognosis of sepsis-induced acute lung injury

作　　者：王晓林[1] 李静 范志强[1] 佟庆[1] 黄艳丽 WANG Xiao-lin;LI Jing;FAN Zhi-qiang;TONG Qing;HUANG Yan-li(Department of Internal Medicine ICU,First Hospital of Qinhuangdao,Qinhuangdao 066000,Hebei,China)

机构地区：[1]秦皇岛市第一医院内科ICU,河北秦皇岛066000

出　　处：《川北医学院学报》2024年第2期222-225,共4页Journal of North Sichuan Medical College

基　　金：河北省秦皇岛市科学技术研究与发展计划项目(201902A195)。

摘　　要：目的:分析血清N末端脑钠肽前体(NT-proBNP)、高迁移率族蛋白B1(HMGB1)、可溶性髓系细胞触发受体-1(sICAM-1)水平与在脓毒症急性肺损伤(ALI)预后评估中的价值。方法:选取104例脓毒症ALI患者为研究对象(ALI组),以肺部超声评分(LUS)将其分为轻度组(n=50)、中度组(n=36)、重度组(n=18);另选取80例单纯性脓毒症患者为对照组。采用酶联免疫吸附法检测血清NT-proBNP、HMGB1、sICAM-1水平,以脓毒症ALI患者28 d预后情况将其分为生存组和死亡组,绘制受试者工作特征曲线(ROC)评估NT-proBNP、HMGB1、sICAM-1及联合预测预后的价值。结果:脓毒症ALI组NT-proBNP、HMGB1、sTREM-1水平均高于对照组(P<0.05);不同严重程度的脓毒症ALI组患者NT-proBNP、HMGB1、sTREM-1值比较,差异均有统计学意义(P<0.05),且均表现为脓毒症ALI轻度组患者<中度组<重度组(P<0.05);Spearman相关性分析显示,NT-proBNP、HMGB1、sTREM-1与严重程度正相关(P<0.05);生存组NT-proBNP、HMGB1、sTREM-1水平均低于死亡组(P<0.05),三者联合检测预测预后的曲线下面积高于单一指标预测。结论:脓毒症ALI患者血清NT-proBNP、HMGB1、sTREM-1水平较高,三者联合检测对于预后有较高的评估价值。Objective:To analyze the evaluation value of serum N-terminal pro brain natriuretic peptide(NT-proBNP),high mobility group protein B1(HMGB1)and soluble intracellular adhesion molecule-1(sICAM-1)in prognosis of sepsis-induced acute lung injury(ALI).Methods:A total of 104 patients with sepsis-induced ALI were enrolled as the observation objects(ALI group).According to lung ultrasound score(LUS),they were divided into mild group(n=50),moderate group(n=36)and severe group(n=18).A total of 80 patients only with sepsis were enrolled as control group.The levels of serum NT-proBNP,HMGB1 and sICAM-1 were detected by enzyme-linked immunosorbent assay(ELISA).According to 28 d prognosis,patients with sepsis-induced ALI were divided into survival group and death group.The prognostic value of NT-proBNP,HMGB1,sICAM-1 and combined detection was evaluated by receiver operating characteristic(ROC)curves.Results:The levels of NT-proBNP,HMGB1 and sTREM-1 in sepsis-ALI group were higher than those in control group(P<0.05),and the differences among mild group,moderate group and severe group were also statistically significant(P<0.05),and the severe group was greater than the moderate and mild groups,the moderate group was greater than the mild group(P<0.05).Spearman correlation analysis showed that NT-proBNP,HMGB1 and sTREM-1 were positively correlated with disease severity(P<0.05).The levels of NT-proBNP,HMGB1 and sTREM-1 in survival group were lower than those in death group(P<0.05).The area under the curve(AUC)of NT-proBNP combined with HMGB1 and sTREM-1 for predicting prognosis was greater than that of single index.Conclusion:The levels of serum NT-proBNP,HMGB1 and sTREM-1 are high in patients with sepsis-induced ALI,and combined detection of the three indexes has high evaluation value for prognosis.

关 键 词：脓毒症 急性肺损伤 NT-PROBNP HMGB1 STREM-1 预后 

分 类 号：R563.1[医药卫生—呼吸系统] R446.1[医药卫生—内科学]