本文選題：mtDNA + ARDS　； 參考：《東南大學(xué)》2017年碩士論文

【摘要】：目的:觀察ARDS患者血漿線粒體DNA(mitochondria DNA,mtDNA)水平及其對(duì)ARDS嚴(yán)重程度及預(yù)后的預(yù)測價(jià)值。方法:單中心、前瞻性、觀察性研究,以2016年05月01日至2017年01月31日期間收住東南大學(xué)附屬中大醫(yī)院重癥醫(yī)學(xué)科的符合納入標(biāo)準(zhǔn)(發(fā)病48h以內(nèi))的ARDS的患者為研究對(duì)象。記錄患者一般資料,包括姓名、性別、年齡、入ICU診斷、既往基礎(chǔ)疾病、ARDS病因;記錄患者入組第1、3、7天呼吸機(jī)參數(shù)(吸入氧濃度、PEEP、氣道峰壓);記錄患者APACHE Ⅱ評(píng)分、SOFA評(píng)分、Murray評(píng)分、病程中是否合并Sepsis、AKI等�；颊呷虢M當(dāng)天記錄為第1天,在患者入組1、3、7天分別留取血標(biāo)本檢測動(dòng)脈血?dú)�、C-反應(yīng)蛋白(CRP)、降鈣素原(PCT)水平及血漿線粒體DNA(mtDNA)水平。隨訪至28天,記錄28天病死率、機(jī)械通氣時(shí)間、ICU住院時(shí)間,用ROC曲線下面積評(píng)估m(xù)tDNA水平對(duì)28天病死率的預(yù)測價(jià)值。結(jié)果:研究期間共確診136例ARDS患者,納入符合標(biāo)準(zhǔn)73例,28天病死率39.7%�；颊卟∏閲�(yán)重程度越高,血漿中mtDNA水平越高,mtDNA可以反映ARDS患者病情的嚴(yán)重程度。與存活組患者相比,死亡組患者第7天血漿中mtDNA 水平顯著增高[67608copies/ul(19498-346736)vs.7585copies/ul(1717-15792),P0.05]。ARDS患者第1、3天的血漿mtDNA水平對(duì)預(yù)后無預(yù)測價(jià)值,第7天血漿mtDNA水平對(duì)預(yù)后有預(yù)測價(jià)值,最佳預(yù)測閾值為18640copies/ul。對(duì)ARDS患者28天病死率的預(yù)測價(jià)值,mtDNA與PaO2/FiO2相比無統(tǒng)計(jì)學(xué)差異(AUC0.73 vs.0.68,P0.05)。結(jié)論:血漿中mtDNA水平能夠反映ARDS患者病情的嚴(yán)重程度,預(yù)測ARDS患者預(yù)后,可以作為判斷ARDS嚴(yán)重程度及預(yù)后的一種生物標(biāo)志物。
[Abstract]:Aim: to observe the plasma mitochondrial DNA(mitochondria mtDNA (mtDNA) level in patients with ARDS and its prognostic value in predicting the severity of ARDS. Methods: single center, prospective and observational study was conducted. Patients with ARDS who were admitted to the Department of intensive Medicine, affiliated Chinese University Hospital of Southeast University (within 48 hours of onset) from 01st May 2016 to January 31 2017, were selected as the study subjects. The general data of the patients were recorded, including name, sex, age, diagnosis of ICU, etiology of previous underlying diseases, ventilator parameters (inhaled oxygen concentration, peak airway pressure) and APACHE 鈪，

本文編號(hào)：1942547