本文關鍵詞： 急性呼吸窘迫綜合征 肺損傷 膿毒癥 白介素 血管性血友病因子 肺表面活性蛋白D　出處：《臨床檢驗雜志》2017年02期 　論文類型：期刊論文

【摘要】：目的從D二聚體(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型鈉尿肽前體(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)中篩選對膿毒癥并發(fā)急性呼吸窘迫綜合征(ARDS)具有預測價值的生物標志物。方法對48例膿毒癥合并ARDS的患者和同期40例膿毒癥患者進行前瞻性對照研究;在進入ICU 24 h內抽取靜脈血標本,定量檢測7種生物標志物的濃度/活性水平;構建膿毒癥并發(fā)ARDS的風險預測模型和死亡預測模型,用Logistic回歸篩選具有預測價值的生物標志物和臨床指標。結果 SP-D、v WF、IL-8預測膿毒癥合并ARDS的ROC曲線下面積分別為0.758(P0.01)、0.783(P0.01)、0.747(P0.01);三者聯(lián)合時為0.847(P0.001);IL-8、年齡≥60歲、APACHEⅡ積分≥20對膿毒癥合并ARDS具有死亡預測價值,OR值分別為12.138(ln IL-8)(P=0.022)、6.157(P=0.040)、7.415(P=0.014)。結論SP-D、v WF、IL-8對膿毒癥合并ARDS具有早期預測價值,三者聯(lián)合可以提高預測準確度;IL-8對膿毒癥合并ARDS具有死亡預測價值,建議在臨床實踐中結合APACHE II評分、年齡綜合評估。
[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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