外周血C-X-C基序趋化因子配体8、C-X-C基序趋化因子配体10评估病毒性肺炎合并急性呼吸窘迫综合征患者预后作用  

The prognostic value of peripheral blood C-X-C motif chemokine ligand 8 and C-X-C motif chemokine ligand 10 in viral pneumonia patients with acute respiratory distress syndrome

作　　者：姜明明[1] 买智涛[1] 陈洋 万善志 邸庆国[1] JIANG Ming-ming;MAI Zhi-tao;CHEN Yang;WAN Shan-zhi;DI Qing-guo(Department of Respiratory and Critical Care Medicine,Cangzhou Central Hospital,Cangzhou 061000,China)

机构地区：[1]沧州市中心医院呼吸与危重症医学科,河北沧州061000

出　　处：《创伤与急危重病医学》2025年第2期107-112,共6页Trauma and Critical Care Medicine

基　　金：河北省2024年度医学科学研究课题计划(20241405)。

摘　　要：目的探讨外周血C-X-C基序趋化因子配体(CXCL)8、CXCL10对病毒性肺炎(VP)合并急性呼吸窘迫综合征(ARDS)患者预后的评估作用。方法选取2021年1月至2024年1月沧州市中心医院收治的140例VP合并ARDS患者为VP合并ARDS组,男性86例,女性54例,年龄(60.37±7.85)岁,年龄范围为31~82岁;选取同期收治的70例单纯VP患者为单纯VP组,男性45例,女性25例,年龄(60.24±5.36)岁,年龄范围为24~78岁。另选取同期于沧州市中心医院体检的70名健康体检志愿者为健康组,男性44例,女性26例,年龄(60.33±6.08)岁,年龄范围为18~75岁。检测外周血CXCL8、CXCL10水平,比较健康组、单纯VP组、VP合并ARDS组外周血CXCL8、CXCL10水平;根据氧合指数,将VP合并ARDS组患者分为VP合并轻度ARDS患者[200 mmHg<氧合指数≤300 mmHg(1 mmHg=0.133 kPa)]、VP合并中度ARDS患者(100 mmHg<氧合指数≤200 mmHg)及VP合并重度ARDS患者(氧合指数≤100 mmHg),比较VP合并不同程度ARDS患者外周血CXCL8、CXCL10水平。采用多因素logistic回归分析VP合并ARDS患者院内生存结局(住院期间病死)影响因素;绘制受试者操作特征(ROC)曲线分析外周血CXCL8、CXCL10及二者联合对VP合并ARDS患者住院期间病死的评价效能。结果单纯VP组、VP合并ARDS组患者外周血CXCL8、CXCL10水平高于健康组,且VP合并ARDS组患者外周血CXCL8、CXCL10水平高于单纯VP组,差异有统计学意义(P<0.05)。VP合并重度ARDS患者外周血CXCL8、CXCL10水平高于VP合并中度ARDS患者、VP合并轻度ARDS患者,且VP合并中度ARDS患者高于VP合并轻度ARDS患者,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,肺外器官衰竭数≥2个、CXCL8高、CXCL10高为VP合并ARDS患者住院期间病死的独立危险因素,氧合指数高为VP合并ARDS患者住院期间病死的独立保护因素(P<0.05)。ROC曲线结果显示,外周血CXCL8、CXCL10联合评价VP合并ARDS患者住院期间病死的ROC曲线下面积大于外周血Objective To explore the prognostic value of peripheral blood C-X-C motif chemokine ligand(CXCL)8 and CXCL10 in patients with viral pneumonia(VP)complicated with acute respiratory distress syndrome(ARDS).Methods A total of 140 VP patients with ARDS admitted to Cangzhou Central Hospital from January 2021 to January 2024 were selected as VP combined with ARDS group,with 86 males and 54 females,aged(60.37±7.85)years old,the age ranging from 31 to 82 years old.A total of 70 patients with isolated VP admitted in the same period were selected as VP group,including 45 males and 25 females,aged(60.24±5.36)years old,the age ranging from 24 to 78 years old.In addition,a total of 70 healthy volunteers who underwent physical examination in Cangzhou Central Hospital during the same period were selected as the healthy group,with 44 males and 26 females,aged(60.33±6.08)years old,the age ranging from 18 to 75 years old.Levels of peripheral blood CXCL8 and CXCL10 of the healthy group,VP group,and VP combined with ARDS group were measured and compared.Based on the oxygenation index,the patients in the VP combined with ARDS group were divided into mild ARDS[200 mmHg<oxygenation index≤300 mmHg(1 mmHg=0.133 kPa)],moderate ARDS(100 mmHg<oxygenation index≤200 mmHg),and severe ARDS(oxygenation index≤100 mmHg),and the levels of peripheral blood CXCL8 and CXCL10 were compared.Multivariate logistic regression was used to analyze the factors influencing in-hospital mortality in VP combined with ARDS patients.Receiver operator characteristic(ROC)curve was drawn to assess the efficacy of peripheral blood CXCL8,CXCL10,and their combination in predicting in-hospital mortality in VP combined with ARDS patients.Results The levels of peripheral blood CXCL8 and CXCL10 in VP group and VP combined with ARDS group were higher than those in healthy group,and the levels of peripheral blood CXCL8 and CXCL10 in VP combined with ARDS group were higher than those in VP group,the differences were statistically significant(P<0.05).The levels of perip

关 键 词：病毒性肺炎 急性呼吸窘迫综合征 C-X-C基序趋化因子配体8 C-X-C基序趋化因子配体10 预后 

分 类 号：R563.1[医药卫生—呼吸系统]