中国呼吸与危重监护杂志

中国呼吸与危重监护杂志

S100A12 在急性呼吸窘迫综合征患者外周血中的表达及意义

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目的 探讨 S100A12 蛋白水平在急性呼吸窘迫综合征(ARDS)患者外周血中的表达及临床意义。 方法 纳入潍坊医学院附属医院、潍坊市人民医院 2015 年 10 月至 2016 年 12 月收治的 ARDS 患者,根据患者氧合状态选取轻度组(n=20)、中度组(n=20)和重度组(n=20),共 60 例纳入研究。随访患者 30 d 预后情况,分为生存组(n=37)和死亡组(n=23)。选取同期 60 例健康体检者作为对照组。收集所有研究对象临床基本资料。采集所有研究对象清晨空腹静脉血 4 ml,采用 ELISA 方法检测血清中 S100A12 的表达。 结果 与对照组比较,ARDS 患者血清中 S100A12、白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)水平以及急性生理学和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分显著升高,PaO 2/FiO 2 明显降低,差异有统计学意义(均 P<0.05)。S100A12 水平与 ARDS 严重程度呈正相关,重度组患者血清中 S100A12 水平高于中度组,中度组高于轻度组,差异有统计学意义(均P<0.05)。ARDS 患者血清中 S100A12 水平与 IL-1、TNF-α、APACHEⅡ评分呈正相关(P<0.05),而与 PaO 2/FiO 2 呈负相关(P<0.05)。对死亡组有关影响因素进行 Logistic 回归分析显示 IL-1、TNF-α、APACHEⅡ评分、S100A12 是 ARDS 患者死亡的独立危险因素,PaO 2/FiO 2 则是 ARDS 患者死亡的独立保护因素。ARDS 患者血清中 S100A12 蛋白水平在预后评估时的 ROC 曲线下面积表明 S100A12 蛋白水平对 ARDS 的转归有一定的预测价值,可作为预后评估的辅助性指标。 结论 ARDS 患者血清中 S100A12 水平显著升高,与病情严重程度密切相关,对 ARDS 早期诊断、治疗及预后有着一定的临床应用价值。

Objective To investigate the expression of S100A12 protein in peripheral blood of patients with acute respiratory distress syndrome (ARDS) and its clinical significance. Methods Sixty ARDS patients admitted between October 2015 and December 2016 were included in the study. They were divided into a mild group (n=20), a moderate group (n=20) and a severe group (n=20) according to the oxygenation state. Meanwhile they were divided into a survival group (n=37) and a death group (n=23) according to the 30-day prognosis. Sixty simultaneous healthy subjects were selected as a control group. The clinical data of all subjects were collected. Fasting venous blood was collected in the morning for measurement of S100A12 expression in peripheral blood by ELISA method. Results Compared with the control group, the levels of S100A12, interleukin-1 (IL-1), tumor necrosis factor alpha (TNF-α) in peripheral blood and APACHEⅡ score were significantly increased in the ARDS patients, and PaO 2/FiO 2 was significantly decreased (all P<0.05). The level of S100A12 in peripheral blood was positively correlated with the severity of ARDS. The level of S100A12 was much higher in the severe group than that in the moderate group and the mild group, and higher in the moderate group than that in the mild group (allP<0.05). Correlation analysis showed that S100A12 level in peripheral blood of the ARDS patients was positively correlated with IL-1, TNF-α and APACHEⅡ score (P<0.05), but negatively correlated with PaO 2/FiO 2 (P<0.05). Logistic regression analysis showed that IL-1, TNF-α, APACHEⅡ score and S100A12 were independent risk factors for prognosis of ARDS. PaO 2/FiO 2 was an independent protective factor for prognosis of ARDS. ROC curve analysis showed that the S100A12 level had a certain predictive value for ARDS and could be used as a prognostic indicator. Conclusions The level of S100A12 in peripheral blood of ARDS patients is significantly increased and is closely related to the severity of ARDS. It has a potential clinical value for early diagnosis, treatment and prognosis of ARDS.

关键词: 急性呼吸窘迫综合征; 钙结合蛋白; 预后

Key words: Acute respiratory distress syndrome; Calcium-binding protein; Prognosis

引用本文: 高继青, 高名同, 李来传, 谭强, 陈京霞, 刘美娟, 史有奎. S100A12 在急性呼吸窘迫综合征患者外周血中的表达及意义. 中国呼吸与危重监护杂志, 2017, 16(5): 457-461. doi: 10.7507/1671-6205.201704034 复制

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