肺挫伤患者早期外周血细胞因子水平的改变及临床意义

发布时间：2018-06-13 01:49

本文选题：肺挫伤 + 急性呼吸窘迫综合征　；参考：《中国实验诊断学》2017年03期

【摘要】：目的检测肺挫伤患者早期外周血细胞因子水平,并分析其对伤后并发急性呼吸窘迫综合征(ARDS)的预测诊断价值,以期为临床诊疗提供参考。方法分析2013年1月至2016年1月在我院ICU接受诊疗的因胸外伤所致肺挫伤患者的临床资料。依据伤后1周内是否发生ARDS将患者分为观察组(ARDS)及对照组(非ARDS)。检测对比两组外周血细胞/炎症因子水平。结果共纳入观察组45例,对照组43例。两组患者外周血IL-10水平比较无显著性差异(P0.05)。观察组患者外周血CRP、TNF-α及DD水平均显著高于对照组患者(P0.05)。相关性分析显示,观察组患者外周血CRP、TNF-α及DD水平呈现两两显著正相关关系(P0.05)。ROC曲线分析显示,以20.93ng/L为截点值,TNF-α预测肺挫伤后并发ARDS的敏感性为86.67%,特异性为81.40%,曲线下面积为0.90,优于CRP及DD。结论肺挫伤后外周血炎症因子及DD水平显著升高,这些指标对预测ARDS的发生具有一定预测价值,其中TNF-α诊断价值最佳。
[Abstract]:Objective to detect the level of cytokines in peripheral blood of patients with pulmonary contusion in early stage, and to analyze the predictive value of cytokines in patients with acute respiratory distress syndrome (ARDS) after injury in order to provide reference for clinical diagnosis and treatment. Methods the clinical data of pulmonary contusion caused by thoracic trauma in ICU from January 2013 to January 2016 were analyzed. According to whether ARDS occurred within 1 week after injury, the patients were divided into two groups: the observation group (ARDS) and the control group (non-ARDS). The levels of peripheral blood cells / inflammatory factors were measured and compared between the two groups. Results there were 45 cases in the observation group and 43 cases in the control group. There was no significant difference in the level of IL-10 between the two groups (P 0.05). The levels of TNF- 伪 and DD in peripheral blood of patients in the observation group were significantly higher than those in the control group (P 0.05). Correlation analysis showed that the levels of TNF- 伪 and DD in the peripheral blood of the patients in the observation group were significantly positively correlated with each other. The sensitivity of TNF- 伪 in predicting ARDS after pulmonary contusion was 86.67, the specificity was 81.40 and the area under the curve was 0.90, which was superior to CRP and DD. Conclusion the levels of inflammatory cytokines and DD in peripheral blood after pulmonary contusion were significantly increased. These indexes have certain predictive value in predicting the occurrence of ARDS, among which TNF- 伪 is the best in the diagnosis of ARDS.
【作者单位】：攀枝花市中心医院检验科;攀枝花市仁和区人民医院检验科;
【分类号】：R563;R446.1

【相似文献】