本文選題：急性呼吸窘迫綜合征 + Dc��； 參考：《重慶醫(yī)科大學(xué)學(xué)報(bào)》2017年12期

【摘要】：目的:探討血清Dc R3(Decoy receptor 3)在急性呼吸窘迫綜合征(acute respiratory distress syndrome,ARDS)預(yù)后評(píng)估中的價(jià)值。方法:采納前瞻性巢式病例對(duì)照研究設(shè)計(jì)方案。觀察42例急性呼吸窘迫綜合征患者30 d預(yù)后,21例全因死亡患者納入死亡組,21例存活患者納入存活組。分析0~24 h血清Dc R3與ARDS病情嚴(yán)重程度、MODS、全因死亡的關(guān)系。結(jié)果:30天全因死亡率為50.0%。輕、中、重度ARDS死亡率分別為23.1%、60.9%、66.7%。輕、中、重度ARDS患者血清Dc R3濃度分別為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。死亡組與存活組血清Dc R3濃度分別為3.1(2.4~5.5)ng/mL、1.8(1.1~2.7)ng/mL,P=0.014。并發(fā)MODS與未并發(fā)MODS患者基線血清Dc R3濃度分別為3.6(2.4~5.5)ng/mL、1.8(1.1~2.9)ng/mL,P=0.011。Cox回歸分析顯示Dc R3≥2.7 ng/mL(HR=2.557,95%CI=1.016~6.432,P=0.046)、并發(fā)MODS(HR=4.667,95%CI=1.751~12.443,P=0.020)、氧合指數(shù)≤165 mm Hg(HR=2.737,95%CI=1.049~7.141,P=0.040)是ARDS患者30 d死亡的獨(dú)立預(yù)后預(yù)測因子。結(jié)論:血清Dc R3濃度高低與ARDS病情嚴(yán)重程度相關(guān)。ARDS患者早期血清Dc R3濃度增高與發(fā)生MODS以及30 d全因死亡風(fēng)險(xiǎn)增高有關(guān)。
[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，

本文編號(hào)：1891046