Clinical significance of IL-8in exhaled breath condensate and serum of patients with acute respiratory distress syndrome
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摘要: 目的:通过检测急性呼吸窘迫综合征(ARDS)患者呼出气冷凝液(EBC)和血清中IL-8的含量,探讨其与ARDS严重程度、临床指标及预后的关系。方法:以行机械通气的ARDS患者为研究组,共45例,根据柏林诊断标准分为轻度组、中度组和重度组;按病因分为肺内源性组及肺外源性组;按预后分为存活组和死亡组,同时选择15例健康人为对照组。检测各组患者EBC和血清中IL-8的含量,采集各组患者急性生理和慢性健康状况评分Ⅱ(APACHEⅡ)评分、氧合指数及PiCCO监测参数。结果:① ARDS组患者血清和EBC中IL-8均明显高于对照组;②随着ARDS程度的加重,患者血清和EBC中IL-8水平相应的升高;③肺内源性ARDS组EBC中的IL-8含量明显高于肺外源性ARDS组(P<0.05);④ ARDS死亡组EBC中IL-8含量明显高于存活组(P<0.05);⑤ ARDS患者EBC中IL-8水平与APACHEⅡ评分、PVPI及EVLWI成正相关,与氧合指数成负相关,而血清中IL-8水平仅与APACHEⅡ评分成正相关。结论:ARDS患者EBC和血清中IL-8的检测,对于ARDS的诊断,病情评估和预后判断有很大帮助。Abstract: Objective:To detect the changes of IL-8 in exhaled breath condensate (EBC) and serum of patients with acute respiratory distress syndrome (ARDS) and to explore its relationship with severity, type, clinical indicators and prognosis of ARDS.Method:Forty-five mechanical ventilation patients with ARDS were selected in the study.The patients were divided into mild, moderate and severe groups according to the Berlin Definition.They were also divided into pulmonary endogenous and extrapulmonary groups according to the etiology.The patients were divided into survival group and death group according to prognosis.Fifteen healthy persons were selected as control group.IL-8 in serum and EBC were detected in all groups.APACHEⅡ score, results of blood gas analysis and pulse index continuous cardiac output (PiCCO) parameters were noted.Result:① IL-8 in serum and EBC were significantly higher in ARDS group than in the healthy control group. ② The level of IL-8 in serum and EBC in ARDS patients increased with the aggravation of ARDS. ③ The level of IL-8 in EBC in the Pulmonary endogenous group was significantly higher than that in the Extrapulmonary group (P<0.05). ④ The level of IL-8 in EBC in ARDS death group was significantly higher than that in ARDS survival group (P<0.05). ⑤ The level of IL-8 in EBC in ARDS group was positively correlated with APACHEⅡ score, PVPI and EVLWI, and negatively correlated with PaO2/FiO2.But the level of IL-8 in the serum was only positively correlated with APACHE score.Conclusion:The test of IL-8 in EBC and serum of ARDS patients can contribute to their diagnosis, condition evaluation and prognosis.
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