| 王飞.中性粒细胞胞外诱捕网对急性呼吸窘迫综合征病情进展及死亡预测的应用价值[J].浙江中西医结合杂志,2025,35(1): |
| 中性粒细胞胞外诱捕网对急性呼吸窘迫综合征病情进展及死亡预测的应用价值 |
| The application value of neutrophil extracellular trapping net in the assessment of acute respiratory distress syndrome and the prediction of death |
| 投稿时间：2024-01-23 修订日期：2024-08-12 |
| DOI： |
| 中文关键词: 【关键词】急性呼吸窘迫综合征 中性粒细胞胞外诱捕网 病情 死亡 预测 |
| 英文关键词:【Key words】acute respiratory distress syndrome neutrophil extracellular trapping net sate of the disease death forecast |
| 基金项目: |
|
| 摘要点击次数: 385 |
| 全文下载次数: 19 |
| 中文摘要: |
| 【】目的 分析中性粒细胞胞外诱捕网(neutrophil extracelluar traps,NETs)对急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)病情进展及死亡预测的应用价值。方法 采取前瞻性对照研究,选择我院自2021年1月至2023年1月收治的150例ARDS患者作为观察组,根据氧合指数(oxygenation index,OI)分为重度亚组(64例,OI≤100mmHg)和非重度亚组(86例,OI＞100mmHg)；另选同期的150例健康体检者作为对照组。比较观察组与对照组、重度亚组与非重度亚组血清NETs的标记物游离DNA(cf-DNA/NETs)、急性生理学与慢性健康状况评分系统Ⅱ(acute physiology and chronic health evaluation scoring system Ⅱ,APACHEⅡ)评分、OI,分析ARDS患者治疗前血清cf-DNA/NETs与APACHEⅡ评分、OI的关系。使用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析cf-DNA/NETs对ARDS患者病死的预测效能。结果 观察组治疗前cf-DNA/NETs、APACHEⅡ评分均高于对照组,OI小于对照组,差异有统计学意义(P＜0.05)；重度亚组治疗前cf-DNA/NETs、APACHEⅡ评分均高于对照组,OI小于非重度亚组,差异有统计学意义(P＜0.05)；治疗72h,两组cf-DNA/NETs、APACHEⅡ评分均较治疗前降低,OI较治疗前增大,组间差异均有统计学意义(P＜0.05)；经Pearson相关性分析,ARDS患者治疗前cf-DNA/NETs与APACHEⅡ评分呈正相关(P＜0.05),与OI呈负相关(P＜0.05)；病死组治疗前及治疗72h血清cf-DNA/NETs水平均高于存活组,差异均有统计学意义(P＜0.05)；经ROC曲线分析,ARDS患者治疗前三者联合预测其病死的AUC为0.911,大于cf-DNA/NETs的0.726、APACHEⅡ评分的0.603和OI的0.657,差异均有统计学意义(P＜0.05)。结论 NETs在ARDS患者外周血中呈高表达,与患者病情严重程度有关。cf-DNA/NETs、APACHEⅡ评分以及OI三者联合预测死亡的效能较好,可作为评估病情及预后的辅助指标,值得进一步研究应用。 |
| 英文摘要: |
| 【】Objective To analyze the application value of neutrophil extracellular trapping NETs (neutrophil extracelluar traps,NETs) in the assessment of acute respiratory distress syndrome (acute respiratory distress syndrome,ARDS) and the prediction of death. Methods 150 ARDS patients admitted to our hospital from January 2021 to January 2023 were selected as the observation group,and were divided into severe group (64 cases, OI≤100mmHg) and non-severe group (86 cases, OI>100mmHg) according to oxygenation index (oxygenation index,OI).Another 150 healthy subjects in the same period were selected as control group.Serum NETs markers free DNA(cf-DNA/NETs),Acute Physiology and Chronic Health Status Score System Ⅱ(acute physiology and chronic health evaluation scoring system Ⅱ,APACHEⅡ) score,OI score were compared between observation group and control group before treatment,severe group and non-severe group before treatment and 72h after treatment.The relationship between serum cf-DNA/NETs,APACHEⅡ score and OI in ARDS patients before treatment was analyzed.The predictive efficacy of cf-DNA/NETs in ARDS patients was analyzed using receiver operating characteristic curve (receiver operating characteristic curve,ROC).Results Before treatment,cf-DNA/NETs and APACHEⅡ scores in observation group were higher than those in control group,and OI was lower than that in control group,the difference was statistically significant(P<0.05).Before treatment,the scores of cf-DNA/NETs and APACHEⅡ in severe group were higher than those in control group,and OI was lower than that in non-severe group,with statistical significance(P<0.05).After 72 hours of treatment,cf-DNA/NETs and APACHEⅡ scores in both groups were lower than before treatment,and OI was higher than before treatment,with statistical significance between groups(P<0.05).According to Pearson correlation analysis,cf-DNA/NETs were positively correlated with APACHEⅡ score in ARDS patients before treatment(P<0.05),and negatively correlated with OI(P<0.05).The serum cf-DNA/NETs levels in the death group before treatment and 72h after treatment were higher than those in the survival group,and the differences were statistically significant(P<0.05).ROC curve analysis showed that the predictive AUC of serum cf-DNA/NETs in ARDS patients before treatment was 0.726,which was higher than 0.603 in APACHEⅡ score and 0.657 in OI score,with statistical significance(P<0.05).Conclusion NETs are highly expressed in the peripheral blood of ARDS patients,which is related to the severity of the patients" disease. And the three indexes have good efficacy in predicting death,which can be used as an auxiliary indicator to evaluate the disease and prognosis,and is worthy of further study and application. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
