疑难病杂志2024，Vol.23Issue(5)：557-562,6.DOI:10.3969/j.issn.1671-6450.2024.05.010
血清eCIRP、suPAR预测脓毒症致急性呼吸窘迫综合征患者预后的价值分析
Analysis of the value of serum eCIRP and suPAR in predicting prognosis in patients with sepsis-induced acute respir-atory distress syndrome
摘要
Abstract
Objective To investigate the prognostic value of serum extracellular cold-induced RNA-binding protein(eCIRP)and soluble urokinase plasminogen activator receptor(suPAR)in patients with sepsis-induced acute respiratory dis-tress syndrome(ARDS).Methods A total of 84 patients with sepsis-induced ARDS(ARDS group)admitted to Ninth Peo-ple's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2019 to June 2023 were enrolled,and 84 patients with pure sepsis(non-ARDS group)were selected in a 1:1 ratio.According to the prognosis,the patients with sepsis-induced ARDS were divided into death subgroup(37 cases)and survival subgroup(47 cases).Enzyme-linked immunosorbent assay was used to measure serum levels of eCIRP and suPAR.The factors causing mortality in ARDS pa-tients with sepsis and the predictive value of serum eCIRP and suPAR levels were analyzed through multiple Logistic re-gression and ROC curve analysis.Results Compared with the non ARDS group,the serum eCIRP and suPAR levels in the ARDS group increased(t/P=14.330/<0.001,10.632/<0.001);The 90 day mortality rate of 84 patients with sepsis induced ARDS was 44.05%(37/84);The serum eCIRP,suPAR,proportion of septic shock,proportion of mechanical ventilation time≥3d,sequential organ failure assessment(SOFA)score,procalcitonin,and blood lactate in the death subgroup were all higher than those in the survival subgroup(χ2/t/P=13.805/<0.001,5.229/<0.001,10.932/<0.001,4.334/0.037,4.850/<0.001,7.592/<0.001,5.926/<0.001);Increased SOFA score,elevated blood lactic acid,eCIRP and suPAR were independent risk factors for death in patients with sepsis-induced ARDS[OR(95%CI)=1.523(1.123-2.067),2.558(1.123-5.824),1.094(1.017-1.178),1.365(1.117-1.670)].The AUC of serum eCIRP,suPAR,and their combination for predicting the death of patients with sepsis-induced ARDS was 0.787,0.779,and 0.871,respectively.The AUC of the combination of the two levels was greater than that of serum eCIRP or suPAR levels alone(Z/P=2.005/0.045,2.205/0.028).Conclusion Elevated levels of serum eCIRP and suPAR are associated with poor prognosis in sepsis induced ARDS patients,and their combined predic-tive value is high.关键词
脓毒症/急性呼吸窘迫综合征/细胞外冷诱导RNA结合蛋白/可溶性尿激酶纤溶酶原激活物受体/预后Key words
Sepsis/Acute respiratory distress syndrome/Extracellular cold-induced RNA-binding protein/Soluble urokinase plasminogen activator receptor/Prognosis分类
临床医学引用本文复制引用
王雷,应佑国,夏正新,丁艳芬,董锦秀,袁慧敏,张志飞..血清eCIRP、suPAR预测脓毒症致急性呼吸窘迫综合征患者预后的价值分析[J].疑难病杂志,2024,23(5):557-562,6.基金项目
上海市卫生行业临床研究专项项目(20194Y0039) Shanghai Health Industry Clinical Research Special Project(20194Y0039) （20194Y0039）
