人中性粒细胞多肽对急性呼吸窘迫综合征患者病情及预后的评估作用  

Evaluation function of human neutrophil peptides with for severity and prognosis of patients with acute respiratory distress syndrome

作　　者：吴苏龙 曾文美 郑玥 黎毅敏[2] WU Sulong;ZENG Wenmei;ZHENG Yue;LI Yimin(Emergency Intensive Care Unit,Shenzhen Qianhai Shekou Free Trade Zone Hospital,Shenzhen 518067,Guangdong,China;Intensive Care Unit,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 511436,Guangdong,China)

机构地区：[1]深圳市前海蛇口自贸区医院急诊重症医学科,广东深圳518067 [2]广州医科大学附属第一医院重症医学科,广东广州511436

出　　处：《中国现代医生》2024年第36期37-40,118,共5页China Modern Doctor

基　　金：深圳市南山区卫生科技计划项目(NS2021011)。

摘　　要：目的探讨人中性粒细胞多肽(human neutrophil peptides,HNPs)对急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者的病情严重程度及预后的评估作用。方法选取2021年12月至2023年12月收住深圳市前海蛇口自贸区医院重症医学科(intensive care unit,ICU)ARDS患者80例,在入住ICU 24h内留取患者血浆标本,采用酶联免疫吸附试验检测血浆HNPs浓度。根据ARDS患者28d存亡情况分为存活组(48例)和死亡组(32例),比较两组患者的HNPs浓度与急性生理和慢性健康状况Ⅱ(acute physiology and chronic health evaluation-Ⅱ,APACHE-Ⅱ)评分等临床指标;采用Spearman相关性分析血浆HNPs浓度与APACHEⅡ评分等指标的相关性;通过单因素Logistic回归分析探讨影响ARDS患者死亡的危险因素,对有统计学意义的危险因素采用多因素Logistic回归模型分析死亡优势比。结果死亡组患者的HNPs浓度、APACHEⅡ评分均高于存活组,差异有统计学意义(P<0.001);HNPs浓度与APACHEⅡ评分呈正相关(r=0.344,P<0.001);HNPs、APACHEⅡ评分是影响ARDS患者28d预后的独立危险因素。结论ARDS患者的血浆HNPs可用于ARDS患者病情危重程度和预后的早期评估。Objective To evaluate function of human neutrophil peptides(HNPs)for the severity and prognosis of patients with acute respiratory distress syndrome(ARDS).Methods From December 2021 to December 2023,80 ARDS patients were enrolled in the study from the intensive care unit(ICU)of Shenzhen Qianhai Shekou Free Trade Zone Hospital.Plasma samples were taken within 24 hours after admission to ICU,HNPs concentration was then measured with enzyme-linked immunesorbent assay.Differences in HNPs concentration and acute physiology and chronic health evaluation-Ⅱ(APACHEⅡ)score etc.Clinical index parameters were compared in survival group(n=48)and death group(n=32)based on their 28-day outcomes.The correlation between HNPs concentration and APACHEⅡscore were calculated by Spearman correlation analysis.We analyzed the risk factors for 28 days death of ARDS patients by single-factor Logistic regression,then used the significant risk factors to analyze death odds ratio by multivariate Logistic regression analysis.Results HNPs concentration and APACHEⅡscore of death group was significantly increased than those of survival group(P<0.001).HNPs concentration has a positive correlation with APACHEⅡscore(r=0.344,P<0.001).HNPs and APACHEⅡwere independent prognosis factor of 28-day mortality of ARDS patients.Conclusion Plasma HNPs concentration may be early used to evaluate the severity and prognosis of ARDS patients.

关 键 词：急性呼吸窘迫综合征 人中性粒细胞多肽 急性生理和慢性健康状况Ⅱ评分 预后 

分 类 号：R563.8[医药卫生—呼吸系统]