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  • 叶海燕,王学斌,巨 轩,等.血浆ESM-1对脓毒症ARDS发生预测价值的研究[J].同济大学学报(医学版),2019,40(6):853-858.    [点击复制]
  • YE Hai-yan,WANG Xue-bin,JU Xuan,et al.Predictive value of plasma ESM-1 for acute respiratory distress syndrome in septic patients[J].同济大学学报(医学版),2019,40(6):853-858.   [点击复制]
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血浆ESM-1对脓毒症ARDS发生预测价值的研究
叶海燕,王学斌,巨轩,刘杨,董婷,杨欢
0
(同济大学附属东方医院重症监护室,上海 200120;上海市浦东新区人民医院急诊科,上海 201200)
摘要:
目的 探讨血浆内皮细胞特异性分子-1(endothelial cell specific molecule-1, ESM-1)对脓毒症性急性呼吸窘迫综合征(acute respiratory distress syndrome, ARDS)发生的预测价值。方法 本研究共纳入符合脓毒症诊断标准患者54例,根据在72h内是否并发ARDS将患者分为非ARDS组(n=42例)与ARDS组(n=12例)。分别检测入组第1、2、3、7天患者血浆ESM-1、白细胞(white blood cell, WBC)、C反应蛋白(C-reactive protein, CRP)、白介素6(interleukin 6, IL-6)、降钙素原(procalcitonin, PCT)水平,并计算氧和指数(oxygenation index, OI)。结果 入组第1天的ARDS组患者血浆ESM-1浓度水平明显低于非ARDS组(t=2.778,P=0.009)。血浆ESM-1浓度与OI相关性好。经Logistic回归分析,入组第1天的血浆ESM-1与CRP、IL-6为预测脓毒症患者ARDS发生的独立危险因素,ESM-1的AUC为0.750,cut-off为5.865ng/mL,CRP的AUC为0.736,IL-6的AUC为0.736。结论 第1天的血浆ESM-1与CRP、IL-6为脓毒症患者ARDS发生的独立危险因素,血浆ESM-1作为脓毒症ARDS的预测标记物,有较好的价值。
关键词:  脓毒症  内皮细胞特异性分子-1  生物标记物  急性呼吸窘迫综合征
DOI:10.16118/j.1008-0392.2019.06.015
投稿时间:2019-08-18
基金项目:上海市卫生和计划生育委员会科研课题(201440320);上海市重中之重临床医学中心和重点学科建设项目(2017zz02017)
Predictive value of plasma ESM-1 for acute respiratory distress syndrome in septic patients
YE Hai-yan,WANG Xue-bin,JU Xuan,LIU Yang,DONG Ting,YANG Hua
(Intensive Care Unit, East Hospital, Tongji University School of Medicine, Shanghai 200120, China;Dept. of Emergency, Shanghai Pudong New Area People’s Hospital, Shanghai 201200, Chin)
Abstract:
Objective To assess the predictive value of plasma ESM-1 to acute respiratory distress syndrome(ARDS) in septic patients. Methods Fifty four patients with sepsis were enrolled in the study.Within 72h after admission, ARDS occurred in 12 patients(ARDS group)and did not occur in 42 patients(non-ARDS group). Plasma ESM-1, WBC, CRP, IL-6 and PCT were measured on d1, d3 and d7 after admission, and the oxygenation index(OI) was calculated. Results Plasma ESM-1 level in ARDS group on d1 was significantly lower than that in non-ARDS group(t=2.778, P=0.009). Plasma ESM-1 level was negatively correlated OI at d2, d3 and d3(all P<0.05). Logistic regression analysis showed that plasma ESM-1, CRP and IL-6 levels on d1 were independent risk factors for ARDS in septic patients. The AUC of ESM-1 was 0.750(P=0.009), which was higher than that of CRP and IL-6. The cut-off value of ESM-1 for predicting ARDS was 5.865ng/mL with a sensitivity of 0.786 and a specificity of 0.583. Conclusion The plasma ESM-1, CRP and IL-6 level on the 1st day are associated with the occurrence of ARDS in septic patients, while ESM-1 is a better predictor for sepsis ARDS.
Key words:  sepsis  endothelial cell specific molecule-1  biomarkers  acute respiratory distress syndrome

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