血清DcR3在急性呼吸窘迫综合征预后评估中的价值

发布时间：2018-05-15 04:42

  本文选题：急性呼吸窘迫综合征 + Dc　； 参考：《重庆医科大学学报》2017年12期

【摘要】：目的:探讨血清Dc R3(Decoy receptor 3)在急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)预后评估中的价值。方法:采纳前瞻性巢式病例对照研究设计方案。观察42例急性呼吸窘迫综合征患者30 d预后,21例全因死亡患者纳入死亡组,21例存活患者纳入存活组。分析0~24 h血清Dc R3与ARDS病情严重程度、MODS、全因死亡的关系。结果:30天全因死亡率为50.0%。轻、中、重度ARDS死亡率分别为23.1%、60.9%、66.7%。轻、中、重度ARDS患者血清Dc R3浓度分别为1.8(1.3~2.9)ng/mL、2.4(1.2~4.8)ng/mL、4.0(2.9~5.5)ng/mL,P=0.048。死亡组与存活组血清Dc R3浓度分别为3.1(2.4~5.5)ng/mL、1.8(1.1~2.7)ng/mL,P=0.014。并发MODS与未并发MODS患者基线血清Dc R3浓度分别为3.6(2.4~5.5)ng/mL、1.8(1.1~2.9)ng/mL,P=0.011。Cox回归分析显示Dc R3≥2.7 ng/mL(HR=2.557,95%CI=1.016~6.432,P=0.046)、并发MODS(HR=4.667,95%CI=1.751~12.443,P=0.020)、氧合指数≤165 mm Hg(HR=2.737,95%CI=1.049~7.141,P=0.040)是ARDS患者30 d死亡的独立预后预测因子。结论:血清Dc R3浓度高低与ARDS病情严重程度相关。ARDS患者早期血清Dc R3浓度增高与发生MODS以及30 d全因死亡风险增高有关。
[Abstract]:Objective: to evaluate the prognostic value of serum DC R3(Decoy receptor 3 in acute respiratory distress syndrome (ARDS). Methods: a prospective nested case-control study was adopted. The prognosis of 42 patients with acute respiratory distress syndrome (ARDS) at 30 days was observed. 21 patients with all causes of death were included in the death group and 21 survivors were included in the survival group. The relationship between serum DC R3 and the severity of ARDS was analyzed. Results the death rate of 30 days was 50.0. The mortality rates of mild, moderate and severe ARDS were 23. 1% and 66. 9% and 66. 7%, respectively. The serum levels of DC R3 in patients with mild, moderate and severe ARDS were 1.81.3ng- 2.9ng / mLL 2.4ng / mL1.2ng / mL 4.8ng / mL 4.0ng / mL 2.95.5ng / mLnL = 0.048ng / mL respectively. The serum levels of DC R3 in the dead group and the survival group were 3.1 ~ 2.4ng / mL ~ (1.5) ng / m ~ (-1) and 2.7ng / m ~ (-1) g / m ~ (-1) P ~ (-1), respectively. The baseline serum DC R3 concentrations in patients with and without MODS were 3.62.45.5ng / mLL 1.81.1and 2.9ngP 0.011.Cox regression analysis showed that DC R3 鈮，

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