肺泡表面活性蛋白D、血管性血友病因子及白介素8对脓毒症诱发急性呼吸窘迫综合征的预测和预后意义

发布时间：2018-01-21 09:03

  本文关键词： 急性呼吸窘迫综合征 肺损伤 脓毒症 白介素 血管性血友病因子 肺表面活性蛋白D　出处：《临床检验杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的从D二聚体(D-dimmer)、血管性血友病因子(von Willebrand factor,v WF)、血小板(Platelet,PLT)、氨基末端B型钠尿肽前体(N terminal-pro brain natriuretic peptide,NT-Pro BNP)、白介素6(interleukin-6,IL-6)、白介素8(interleukin-8,IL-8)、肺泡表面活性蛋白D(Surfactant Protein D,SP-D)中筛选对脓毒症并发急性呼吸窘迫综合征(ARDS)具有预测价值的生物标志物。方法对48例脓毒症合并ARDS的患者和同期40例脓毒症患者进行前瞻性对照研究;在进入ICU 24 h内抽取静脉血标本,定量检测7种生物标志物的浓度/活性水平;构建脓毒症并发ARDS的风险预测模型和死亡预测模型,用Logistic回归筛选具有预测价值的生物标志物和临床指标。结果 SP-D、v WF、IL-8预测脓毒症合并ARDS的ROC曲线下面积分别为0.758(P0.01)、0.783(P0.01)、0.747(P0.01);三者联合时为0.847(P0.001);IL-8、年龄≥60岁、APACHEⅡ积分≥20对脓毒症合并ARDS具有死亡预测价值,OR值分别为12.138(ln IL-8)(P=0.022)、6.157(P=0.040)、7.415(P=0.014)。结论SP-D、v WF、IL-8对脓毒症合并ARDS具有早期预测价值,三者联合可以提高预测准确度;IL-8对脓毒症合并ARDS具有死亡预测价值,建议在临床实践中结合APACHE II评分、年龄综合评估。
[Abstract]:Objective to investigate the effects of D-dimmerus, von Willebrand factor-v WFV, platelets. N terminal-pro brain natriuretic peptideNT-Pro BNPs, N-terminal B-type natriuretic peptide precursor. Interleukin-6 Interleukin-6 (IL-6) and Interleukin-8 Interleukin-8 (IL-8). Alveolar surfactant Protein D. Screening for ARDS in sepsis complicated with acute respiratory distress syndrome. Methods 48 patients with sepsis complicated with ARDS and 40 patients with sepsis at the same time were studied by prospective control study. Venous blood samples were collected within 24 hours after entering ICU and the concentration / activity levels of 7 biomarkers were detected quantitatively. The risk prediction model and death prediction model of sepsis complicated with ARDS were constructed, and the biomarkers and clinical indexes with predictive value were screened by Logistic regression. The area under the ROC curve of sepsis with ARDS predicted by IL-8 was 0.758 (P 0.01) and 0.747 (P 0.01), respectively. The combined time of the three was 0.847 (P 0.001); IL-8, age 鈮，

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