血清MIF、MCP-1、suPAR水平与脓毒症严重程度及合并ARDS风险的关系  被引量:3

Relationship between serum levels of MIF,MCP-1,and suPAR and the severity of sepsis and the risk of concomitant ARDS

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作  者:闫晓笑 刘桢干 李燕 杨立明[1] 苗慧慧[1] 王跃敏 YAN Xiao-xiao;LIU Zhen-gan;LI Yan(Department of Critical Care Medicine,General Hospital of Taiyuan Steel(Group)Co.,Ltd,Taiyuan Shanxi 030000,China)

机构地区:[1]太原钢铁(集团)有限公司总医院重症医学科,山西太原030000

出  处:《临床和实验医学杂志》2024年第5期469-473,共5页Journal of Clinical and Experimental Medicine

基  金:山西省卫生健康委科研课题(编号:2019183)。

摘  要:目的探讨血清巨噬细胞迁移抑制因子(MIF)、单核细胞趋化蛋白-1(MCP-1)、可溶性尿激酶型纤溶酶原激活物受体(suPAR)水平与脓毒症严重程度及合并急性呼吸窘迫综合征(ARDS)风险的关系。方法回顾性分析2022年2月至2023年5月太原钢铁(集团)有限公司总医院收治的86例脓毒症患者的临床资料。依据病情程度不同将患者分为脓毒症组(n=20)、严重脓毒症组(n=48)和脓毒症休克组(n=18)。入院72 h内参考ARDS诊断标准将患者分为ARDS组(n=27)和非ARDS组(n=59)。检测并比较各组脓毒症患者血清MIF、MCP-1、suPAR水平。收集ARDS组与非ARDS组患者年龄、性别、体重指数、合并症、感染类型、既往史、心率、急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)、脓毒症相关性器官衰竭评价(SOFA)评分、白细胞计数、血乳酸、天冬氨酸转移酶(AST)、丙氨酸转移酶(ALT)、总胆固醇等指标。采用多因素Logistic回归分析对影响脓毒症患者并发ARDS的危险因素进行分析。通过受试者工作特征(ROC)曲线分析血清MIF、MCP-1、suPAR水平预测脓毒症患者并发ARDS的价值。结果脓毒症休克组患者血清MIF、MCP-1、suPAR水平分别为(94.02±10.13)、(506.55±45.15)、(13.89±3.95)ng/mL,均高于脓毒症组[(76.93±7.01)、(148.38±35.74)、(6.07±2.13)ng/mL]和严重脓毒症组[(85.46±8.74)、(327.08±40.62)、(8.42±1.07)ng/mL],而严重脓毒症组患者血清MIF、MCP-1、suPAR水平均高于脓毒症组,差异均有统计学意义(P<0.05)。ARDS组与非ARDS组患者的年龄、性别构成比、体重指数、合并症、感染类型、白细胞计数、心率、吸烟史、饮酒史、血乳酸、AST、ALT、总胆固醇比较,差异均无统计学意义(P>0.05);ARDS组患者APACHEⅡ评分、SOFA评分、有急腹症和胰腺炎占比及血清MIF、MCP-1、suPAR水平均高于非ARDS组,差异均有统计学意义(P<0.05)。经多因素Logistic回归分析结果显示,急腹症、胰腺炎、APACHObjective To explore the relationship between serum levels of macrophage migration inhibitory factor(MIF),monocyte chemoattractant protein-1(MCP-1),soluble urokinase type plasminogen activator receptor(suPAR)and the severity of sepsis and the risk of acute respiratory distress syndrome(ARDS).Methods A retrospective analysis was conducted on the clinical data of 86 sepsis patients admitted to General Hospital of Taiyuan Steel(Group)Co.,Ltd from February 2022 to May 2023.According to the severity of the condition,patiennts were divided into sepsis group(n=20),severe sepsis group(n=48),and septic shock group(n=18).Within 72 hours of admission,patients were divided into the ARDS group(n=27)and the non ARDS group(n=59)based on the diagnostic criteria for ARDS.And the levels of serum MIF,MCP-1,and suPAR in all patients were detected and compared in each group of sepsis patients.Age,gender,body mass index,comorbidities,infection type,history,heart rate,acute physiology and chronic health status evaluationⅡ(APACHEⅡ),sepsis-related organ failure assessment(SOFA)score,white blood cell count,blood lactate,aspartate aminotransferase(AST),alanine aminotransferase(ALT)and total cholesterol between the ARDS group and the non ARDS group were collected.The risk factors for ARDS in sepsis patients were analyzed using multivariate Logistic regression.The value of serum MIF,MCP-1,and suPAR levels in predicting ARDS in sepsis patients was analyzed through receiver operating characteristic(ROC)curves.Results The levels of serum MIF,MCP-1,and suPAR in the septic shock group were(94.02±10.13),(506.55±45.15),(13.89±3.95)ng/mL,which were higher than those in the sepsis group[(76.93±7.01),(148.38±35.74),(6.07±2.13)ng/mL]and severe sepsis group[(85.46±8.74),(327.08±40.62),(8.42±1.07)ng/mL],the levels of serum MIF,MCP-1,and suPAR in patients of the severe sepsis group were higher than those in the sepsis group,the differences were statistically significant(P<0.05).There was no statistically significant difference in age,gender c

关 键 词:脓毒症 巨噬细胞迁移抑制因子 单核细胞趋化蛋白-1 可溶性尿激酶型纤溶酶原激活物受体 急性呼吸窘迫综合征 

分 类 号:R459.7[医药卫生—急诊医学] R563.8[医药卫生—治疗学]

 

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