肥胖急性呼吸窘迫综合征患者血清趋化素水平改变与临床预后的相关性研究

袁雪丰; 赵扬; 李亮; 孙兆瑞; 任艺; 刘红梅; 聂时南

doi:10.13201/j.issn.1009-5918.2017.04.014

肥胖急性呼吸窘迫综合征患者血清趋化素水平改变与临床预后的相关性研究

- 南京军区南京总医院(南京大学附属金陵医院)急救医学科(南京, 210002)
基金项目:
全军后勤面上项目 (No:CNJ14L002)

国家自然科学基金青年基金课题 (No:81401583)

南京军区南京总医院院管课题 (No:2016032)

详细信息

通讯作者: 聂时南, E-mail:shn_nie@sina.com

中图分类号: R563

收稿日期: 2017-02-14

The correlation analysis between serumchemerin and 28-day mortality in obesity patients with ARDS

- Department of Emergency, Nanjing General Hospital of Nanjing Military Command/Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China

More Information

Corresponding author: NIE Shinan, E-mail: shn_nie@sina.com

Received Date: 14 February 2017

摘要

摘要: 目的: 探讨肥胖急性呼吸窘迫综合征(ARDS)患者血清趋化素(chemerin)水平改变与临床预后的相关性。方法: 连续性纳入2014-06-2016-11在我院住院治疗的80例肥胖ARDS患者。根据28 d死亡事件情况分为死亡组(n=28)和存活组(n=52)。所有患者分别于入组时和入组第3天检测血清chemerin水平,并计算APACHE Ⅱ和SOFA评分。结果: 入组后第3天,死亡组患者chemerin水平明显高于存活组[(35.2±5.7) mg/L vs.(11.5±1.9) mg/L,P<0.05)]。死亡组△chemerin(第3天chemerin-入组时chemerin)明显高于存活组[(15.6±4.1) mg/L vs.(-0.9±0.2) mg/L,P<0.05)]。存活组第3天APACHE Ⅱ评分明显低于死亡组[(18.6±3.9) vs.(27.1±3.3),P<0.05)]。通过ROC曲线分析发现,第3天chemerin水平(AUC=0.733)和△chemerin水平(AUC=0.812)对于ARDS患者28 d死亡风险有一定的预警价值。相关性分析可见第3天chemerin和△chemerin与28 d死亡风险呈正相关(r=0.677、0.623,P<0.05)。通过Logistic回归分析发现第3天chemerin(OR=2.02,95%CI:1.55~3.78,P<0.05)和△chemerin(OR=2.33,95%CI:1.76~3.44,P<0.05)为ARDS患者28 d死亡事件发生的独立危险因素。结论: 肥胖ARDS患者血清chemerin水平明显升高可以作为28 d死亡风险的预警信号。
- 急性呼吸窘迫综合征 /
- 趋化素 /
- 28d死亡风险 /
- 相关性
Abstract: Objective: To evaluate the correlation value between serum chemerin and 28-day mortality in obesity patients with ARDS. Method: From June 2014 to November 2016,eighty ARDS patients were enrolled in this study and divided into survival group(n=52) and death group(n=28) based on 28-day mortality.The levels of chemerin,APACHE Ⅱ and SOFA score were measured on the admission day(T0) and three days later(T1). Result: On the third day,the contents of chemerin in death group were higher than those in survival group[(35.2±5.7) mg/L vs.(11.5±1.9) mg/L,P<0.05].The fluctuation of chemerin(△chemerin) in death group were higher than those in survival group[(15.6±4.1) mg/L vs.(-0.9±0.2) mg/L,P<0.05)].The APACHE Ⅱ score of survival group were lower than that of death group[(18.6±3.9) vs.(27.1±3.3),P<0.05)].ROC analysis showed that chemerin of T3(AUC=0.733)and △chemerin(AUC=0.812)were useful to forecast 28-day mortality.Correlation analysis showed chemerin of T3 and △chemerin were positively related with 28-day mortality(r=0.677,0.623,P<0.05).Logistic regression analysis reminded that chemerin of T3(OR=2.02,95%CI:1.55~3.78,P<0.05) and △chemerin(OR=2.33,95%CI:1.76~3.44,P<0.05)were independent risk factors of 28-day mortality in patients with ARDS. Conclusion: Increasing levels of chemerin may be a warning signal for 28-day mortality in obesity patients with ARDS.
- acuterespiratory distress syndrome /
- chemerin /
- 28-day mortality /
- correlation

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