血清瘦素、IL-13、CC16与严重胸部创伤合并肺挫伤患者预后关系研究  

Relationship between serum leptin,IL-13,CC16 and the prognosis of patients with severe chest trauma complicated by pulmonary contusion

作　　者：温勃阳[1] 何世勇[1] 丁涛[1] WEN Boyang;HE Shiyong;DING Tao(Department of Thoracic Surgery,Taiyuan Central Hospital,Taiyuan 030009,China)

机构地区：[1]太原市中心医院胸外科,山西太原030009

出　　处：《陕西医学杂志》2025年第5期693-696,701,共5页Shaanxi Medical Journal

基　　金：山西省科学技术研究与开发项目(201901D2732130)。

摘　　要：目的:探讨血清瘦素、白细胞介素-13(IL-13)、克拉拉细胞分泌蛋白16(CC16)与严重胸部创伤合并肺挫伤患者预后的关系。方法:选取118例严重胸部创伤合并肺挫伤患者,随访30 d,根据预后情况预后良好组(90例)和预后不良组(28例)。ELISA法检测血清瘦素、IL-13、CC16水平。严重胸部创伤合并肺挫伤患者预后影响因素采用Logistic回归分析。绘制受试者工作特征(ROC)曲线分析血清瘦素、IL-13、CC16对严重胸部创伤合并肺挫伤患者预后不良的预测价值。结果:两组年龄、受伤至入院时间、肺挫伤严重程度及有无休克并发症比较差异有统计学意义(均P<0.05)。预后不良组血清瘦素、IL-13、CC16水平高于预后良好组(均P<0.05)。轻度、中度、重度肺挫伤患者血清瘦素、IL-13、CC16水平依次升高(均P<0.05)。血清瘦素、IL-13、CC16为严重胸部创伤合并肺挫伤患者预后的独立影响因素(均P<0.05)。血清瘦素、IL-13、CC16联合预测严重胸部创伤合并肺挫伤患者预后不良的曲线下面积(AUC)为0.912,大于三者单独预测的AUC(均P<0.05)。结论:血清瘦素、IL-13、CC16与严重胸部创伤合并肺挫伤患者肺挫伤严重程度有关,是患者预后的影响因素,三者联合检测对预后具有较好的预测价值。Objective:To investigate the relationship between serum leptin,interleukin-13(IL-13),Clara cell secretory protein 16(CC16)and the prognosis of patients with severe chest trauma complicated by pulmonary contusion.Methods:A total of 118 patients with severe chest trauma complicated by pulmonary contusion were selected.Follow-up was 30 days,patients were divided into good-prognosis group(90 cases)and poor-prognosis group(28 cases)based on their prognosis.ELISA was used to detect serum levels of leptin,IL-13 and CC16.Logistic regression analysis was used to identify the influencing factors of prognosis in patients with severe chest trauma complicated by pulmonary contusion.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of serum leptin,IL-13 and CC16 for poor prognosis in these patients.Results:Statistically significant differences in age,time from injury to admission,severity of pulmonary contusion and presence of shock complications were compared between the two groups(all P<0.05).Serum leptin,IL-13 and CC16 levels were higher in the poor prognosis group than in the good prognosis group(all P<0.05).Serum leptin,IL-13,and CC16 levels were sequentially increased in patients with mild,moderate,and severe pulmonary contusions(all P<0.05).Serum leptin,IL-13,and CC16 were independent factors affecting the prognosis of patients with severe chest trauma complicated by pulmonary contusion(all P<0.05).The area under the curve(AUC)of the combined prediction of serum leptin,IL-13,and CC16 for poor prognosis in patients with severe chest trauma complicated by pulmonary contusion was 0.912,which was greater than the AUC predicted by each of the three factors alone(all P<0.05).Conclusion:Serum leptin,IL-13 and CC16 are associated with the severity of pulmonary contusion in patients with severe chest trauma complicated by pulmonary contusion,and are factors that affect patient prognosis.Combined detection of the three has good predictive value for prognosis.

关 键 词：严重胸部创伤 肺挫伤 瘦素 白细胞介素-13 克拉拉细胞分泌蛋白16 预后 

分 类 号：R655[医药卫生—外科学]