高频超声评估肱动脉血流介导的血管舒张功能联合血清磷脂酰丝氨酸1磷酸盐预测脓毒症患者血管内皮功能的研究  

Study on the brachial artery FMD function with high-frequency ultrasound assessment combined with S1P in predicting vascular endothelial function of patients with sepsis

作　　者：田茂伦 肖红 程叶锋 Tian Maolun;Xiao Hong;Cheng Yefeng(Department of Ultrasound Medicine,The People's Hospital of Nanchuan Chongqing,Chongqing 408400,China)

机构地区：[1]重庆市南川区人民医院超声医学科,重庆408400

出　　处：《中国医学装备》2024年第8期75-79,95,共6页China Medical Equipment

基　　金：重庆市自然科学基金面上项目(cstc2021jcyj-msxmX0857)。

摘　　要：目的:探讨高频超声评估肱动脉血流介导血管舒张功能(FMD)联合血清磷脂酰丝氨酸1磷酸盐(S1P)水平预测脓毒症患者血管内皮功能的价值。方法:选择2021年2月至2023年2月重庆市南川区人民医院收治的140例脓毒症患者纳入病例组,另选同期在医院进行健康体检的140名志愿者纳入健康对照组。采用高频超声测量两组受试者肱动脉FMD,检测两组血清S1P水平。分析FMD、S1P与脓毒症患者血管内皮功能的相关性,以及FMD、S1P评估脓毒症患者血管内皮功能的诊断效能,分析FMD和S1P水平与脓毒症患者的血管内皮功能评分(VEFS)的相关性。结果:病例组FMD(4.21±1.63)和S1P(0.82±0.24)及VEFS(0.42±0.15)水平均显著低于健康对照组(7.35±2.15,1.28±0.32,0.78±0.18),差异有统计学意义(t=-14.23、-13.56、-17.32,P<0.05),且病例组FMD和S1P水平与VEFS呈显著正相关(r=0.62、0.58,P<0.01),与血清C反应蛋白(CRP)水平呈显著负相关(r=-0.55、-0.51,P<0.01)。FMD和S1P水平作为预测脓毒症患者血管内皮功能的单因素指标,其受试者工作特征(ROC)曲线下面积(AUC)分别为0.83和0.82,灵敏度分别为74.0%和77.0%,特异度分别为78.0%和75.0%。FMD和S1P联合作为预测脓毒症患者血管内皮功能的多因素指标,其AUC为0.90,灵敏度为88.0%,特异度为77.0%。结论:高频超声评估肱动脉FMD联合血清S1P水平可以有效预测脓毒症患者的血管内皮功能,对于脓毒症患者的诊断和治疗具有重要的临床意义。Objective:To explore the value of flow-mediated vasodilation(FMD)of brachial artery,which was assessed by high-frequency ultrasound assessment,combined with serum phosphatidylserine 1 phosphate(S1P)levels in predicting vascular endothelial function of patients with sepsis.Methods:A total of 140 patients with sepsis who admitted to the People's Hospital of Nanchuan Chongqing from February 2021 to February 2023 were selected as the case group,and 140 volunteers who underwent health physical examinations in the hospital during the same period were selected as the healthy control group.High-frequency ultrasound was used to measure the brachial artery FMD of the two groups,and the serum S1P levels of the two groups were also detected.The correlation between FMD,S1P and vascular endothelial function in patients with sepsis was analyzed,as well as the diagnostic performances of FMD and S1P in assessing vascular endothelial function of patients with sepsis.And then,the correlation between FMD,S1P levels and the vascular endothelial function score(VEFS)in patients with sepsis was further analyzed.Results:The FMD(4.21±1.63),S1P(0.82±0.24)and VEFS(0.42±0.15)levels in the case group were significantly lower than those(7.35±2.15,1.28±0.32,0.78±0.18)in the healthy control group(t=-14.23,-13.56,-17.32,P<0.05),respectively.The FMD and S1P levels were significantly positive correlation with VEFS in the case group(r=0.62,0.58,P<0.01),and they were significantly negative correlation with C-reactive protein(CRP)(r=-0.55,-0.51,P<0.01),respectively.As single-factor indicators of predicting vascular endothelial function of patients with sepsis,area under curve(AUC)values of receiver operating characteristic(ROC)curves of FMD and S1P levels were respectively 0.83 and 0.82,and the sensitivities of them were respectively 74.0%and 77.0%,specificities of them were respectively 78.0%and 75.0%.As the multi-factor indicator of predicting vascular endothelial function of patients with sepsis,the AUC,sensitivity and specificity of the comb

关 键 词：高频超声 血流介导的血管舒张功能 肱动脉 磷脂酰丝氨酸1磷酸盐 脓毒症 血管内皮功能 

分 类 号：R445.1[医药卫生—影像医学与核医学]