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中华重症医学电子杂志 ›› 2017, Vol. 03 ›› Issue (04) : 266 -270. doi: 10.3877/cma.j.issn.2096-1537.2017.04.007

所属专题: 文献

临床研究

血乳酸水平联合细胞因子白介素-9评估急性呼吸窘迫综合征预后的价值
谭九根1,(), 归淑华1, 谢建平1, 齐宏宇1, 项美玲1   
  1. 1. 315202 浙江省宁波市第七医院ICU
  • 收稿日期:2016-09-14 出版日期:2017-11-28
  • 通信作者: 谭九根

The prediction value of lactate combined with interleukin-9 in acute respiratory distress syndrome

Jiugen Tan1,(), Shuhua Gui1, Jianping Xie1, Hongyu Qi1, Meiling Xiang1   

  1. 1. Department of ICU, the Seventh Hospital of Ningbo City, Zhenhai District of Zhejiang City of Ningbo Province, Ningbo 315202, China
  • Received:2016-09-14 Published:2017-11-28
  • Corresponding author: Jiugen Tan
  • About author:
    Corresponding author: Tan Jiugen, Email:
引用本文:

谭九根, 归淑华, 谢建平, 齐宏宇, 项美玲. 血乳酸水平联合细胞因子白介素-9评估急性呼吸窘迫综合征预后的价值[J/OL]. 中华重症医学电子杂志, 2017, 03(04): 266-270.

Jiugen Tan, Shuhua Gui, Jianping Xie, Hongyu Qi, Meiling Xiang. The prediction value of lactate combined with interleukin-9 in acute respiratory distress syndrome[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2017, 03(04): 266-270.

目的

探究血乳酸(LAC)水平联合白介素-9(IL-9)测定用于评估急性呼吸窘迫综合征(ARDS)预后的临床价值。

方法

选取2015年8月至2016年7月在宁波市第七医院就诊的ARDS患者44例,根据2012年柏林定义的ARDS将患者分为中度组(24例)与重度组(20例),另选同时期40名健康体检者为健康对照组。ARDS患者确诊的第l天与第3天抽取外周静脉血3 ml,检测肺功能、血清IL-9及LAC浓度。治疗后30 d对患者进行随访,将患者分为存活组与死亡组,采用ROC曲线分析LAC联合IL-9检测对预后的评估价值。

结果

ARDS组患者第1天外周静脉血清IL-9及LAC水平明显高于健康对照组[(4.31±1.86)pg/ml vs(2.31±0.81)pg/ml,(8.5±4.0)mmol/Lvs(2.1±2.7)mmol/L],差异均有统计学意义(t=6.31、7.42,P均<0.05)。将中度组与重度组患者进行比较,第1天IL-9及LAC水平比较,差异均无统计学意义(P均>0.05);中度组患者第3天外周静脉血清IL-9及LAC水平低于重度组患者[(3.21±1.07)pg/ml vs(4.37±1.01)pg/ml,(7.1±1.0)mmol/L vs(8.0±1.5)mmol/L],差异均有统计学意义(t=-3.67、-3.42,P均<0.05)。将存活组与死亡组比较,确诊ARDS第1天,存活组与死亡组患者外周静脉血清IL-9水平比较,差异无统计学意义(P>0.05),LAC水平比较[(6.2±1.4)mmol/L vs(8.4±1.9)mmol/L],差异有统计学意义(t=-4.48,P<0.05)。死亡组患者第3天外周静脉血清LAC及IL-9水平明显高于存活组[(3.02±0.97)pg/ml vs(4.11±0.54)pg/ml,(5.0±1.3)mmol/L vs(7.2±1.8)mmol/L],差异均有统计学意义(t=-3.99、-3.67,P均<0.05)。采用ROC曲线评估患者预后,LAC联合IL-9检测敏感度95.65%,特异度90.48%,Youden指数86.13%,高于2项指标单独检测。

结论

LAC联合IL-9测定有助于评估ARDS患者的预后。

Objective

To explore the prediction value of lactic acid (LAC) combined with interleukin-9 (IL-9) in acute respiratory distress syndrome (ARDS).

Methods

From Aug. 2015 to Jul. 2016, 44 ARDS patients were enrolled and divided into moderate ARDS group (24 cases) and severe ARDS group (20 cases) according to Berlin ARDS criterion. Forty healthy volunteers were enrolled in the control group. Using double antibody sandwich enzyme-linked immunosorbent assay for peripheral venous IL-9 and LAC examination in both groups. All patients were followed up for at least 30 days and then divided into survival group (23 cases) and non-survival group (21 cases). The prediction value of combining these two parameters was analyzed by ROC curve.

Results

The levels of IL-9 and LAC in ARDS group were higher than those in control group [(4.31±1.86) pg/ml vs (2.31±0.81) pg/ml, (8.5±4.0) mmol/L vs (2.1±2.7) mmol/L] at the first day, the difference was statistically significant (t=6.31, 7.42, all P<0.05). There was no significant difference in IL-9 and LAC levels between moderate ARDS patients and severe ARDS patients at the first day (all P>0.05); the LAC and IL-9 levels in moderate group were lower than those in severe group at the third day [(3.21±1.07) pg/ml vs (4.37±1.01) pg/ml, (7.1±1.0) mmol/L vs (8.0±1.5) mmol/L], the difference was statistically significant (t=-3.67, -3.42, all P<0.05). There was no difference in IL-9 level between survival group and non-survival group at the first day (P>0.05), but lactate level in the same day between these two groups are different [(6.2±1.4) mmol/L vs (8.4±1.9) mmol/L], the difference was statistically significant (t=-4.48, P<0.05). The levels of LAC and IL-9 in non-survival group were significantly higher than those in survival group at the third day [(3.02±0.97) pg/ml vs (4.11±0.54) pg/ml, (5.0±1.3) mmol/L vs (7.2±1.8) mmol/L], the difference was statistically significant (t=-3.99, -3.67, P<0.05). In ROC curve, the sensitivity of prediction value for these two combined parameters was 95.65% and the specificity was 90.48%, which meant combination of these two parameters were better than separate use either of them.

Conclusion

Combined determination of LAC and IL-9 in patients with acute respiratory distress syndrome is helpful to predict the prognosis in these patients.

表1 ARDS组与健康对照组一般资料比较
表2 ARDS组与健康对照组IL-9与LAC水平比较(±s
表3 ARDS患者中度组与重度组IL-9与LAC水平比较(±s
表4 ARDS患者存活组与死亡组IL-9与LAC水平比较(±s
图1 血乳酸与IL-9水平诊断效能ROC曲线
表5 LAC水平与IL-9单独检测与联合检测的对预后的诊断效能比较
1
Schuster DP, Kollef MH. Acute respiratory distress syndrome [J]. Dis Mon, 1996, 42(5):270-326.
2
Bochud PY, Calandra T, Francioli P. Bacteremia due to viridans streptococci in neutropenic patients: a review [J]. Am J Med, 1994, 97(3):256-264.
3
Gpa Neto A, Schmidt M, Azevedo LC, et al. Associations between ventilator settings during extracorporeal membrane oxygenation for refractory hypoxemia and outcome in patients with acute respiratory distress syndrome: a pooled individual patient data analysis: Mechanical ventilation during ECMO [J]. Intensive Care Med, 2016, 5(1):54-59.
4
Chen W, Ware LB. Prognostic factors in the acute respiratory distress syndrome [J]. Clin Transl Med, 2015, 4(1):65.
5
郭禹标,谢灿茂. 巨噬细胞移动抑制因子在急性呼吸窘迫综合征发病中的作用 [J]. 中华结核和呼吸杂志, 2002, 25(6):337-340.
6
Gralinski LE, Bankhead A 3rd, Jeng S, et al. Mechanisms of severe acute respiratory syndrome coronavirus-induced acute lung injury [J]. MBio, 2013, 4(4):e00271-e00213.
7
Gaggar A, Patel RP. There is blood in the water: Hemolysis, hemoglobin, and heme in acute lung injury [J]. Am J Physiol Lung Cell Mol Physiol, 2016, 14(4):97.
8
Meduri GU, Schwingshackl A, Hermans G. Prolonged Glucocorticoid Treatment in ARDS: Impact on Intensive Care Unit-Acquired Weakness [J]. Front Pediatr, 2016, 24(11):652-655.
9
Williams AE, José RJ, Mercer PF, et al. Evidence for chemokine synergy during neutrophil migration in ARDS [J]. Thorax, 2016, 5(2):43-48.
10
Chen C, Shi L, Li Y, et al. Disease-specific dynamic biomarkers selected by integrating inflammatory mediators with clinical informatics in ARDS patients with severe pneumonia [J]. Cell Biol Toxicol, 2016, 32(3):169-184.
11
闫丽娜,傅强,杜超, 等. 阳明腑实证合并急性肺损伤/急性呼吸窘迫综合征患者预后因素分析:附206例多中心报告 [J]. 中华危重病急救医学, 2015, 27(7):548-551.
12
Du H, Wang PZ, Li J, et al. Clinical characteristics and outcomes in critical patients with hemorrhagic fever with renal syndrome [J]. BMC Infect Dis, 2014, 13(4):78-81.
13
Rao H, Beixi MO. Clinical value of lactic acid quantitative stratification in acute respiratory distress syndrome patients [J]. China Medical Herald, 2011, 24(2):116-119.
14
Kimura D, Saravia JS, Rovnaghi C, et al. 669: THE EFFECT OF LOW DOSE METHYLPREDNISOLONE ON BIOMARKER LEVELS IN EARLY PEDIATRIC ARDS [J]. Crit Care Med, 2015, 43(12 Suppl 1):169.
15
Ciccia F, Guggino G, Rizzo A, et al. Potential involvement of IL-9 and Th9 cells in the pathogenesis of rheumatoid arthritis [J]. Rheumatology, 2015, 54(12):580-583.
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