ARDS患者血清CC-16水平及临床诊断价值研究
Serum levels and clinical significance of CC-16 in patients with acute respiratory distress syndrome
胡忠 1王进 1郑娟1
作者信息
- 1. 401121 重庆两江新区第一人民医院呼吸科
- 折叠
摘要
目的 探讨急性呼吸窘迫综合征(ARDS)患者血清Clara细胞分泌蛋白-16(clara cell protain-16,CC-16)水平及诊断ARDS的临床价值.方法 纳入2011年10月至2016年2月就诊的ARDS患者62例(ARDS组),同时纳入44例健康人作为对照(健康对照组).患者就诊时记录一般情况、检测肺功能、动脉血气分析等常规指标,酶联免疫法检测血清CC-16、脑钠肽(BNP)水平.分析CC-16与临床指标的相关性,ROC曲线考察诊断价值.结果 ARDS组CC-16水平显著高于健康对照组,差异有统计学意义[(19.89±8.59) vs.(11.04±4.77)ng/ml,P<0.01].ARDS不同严重程度患者CC-16水平由高至低为:重度ARDS组[(26.46±7.58)ng/ml]、中度ARDS组[(19.64±7.01)ng/ml]及轻度ARDS组[(12.94±6.08)ng/ml].ARDS组中,CC-16与APACHEⅡ评分(r=0.583,P<0.01)、SOFA评分(r=0.536,P<0.01)及BNP(r=0.427,P<0.01)呈显著正相关,与PaO2/FiO2(r=-0.650,P<0.01)呈显著负相关.血清CC-16水平单独用于ARDS的诊断的AUC为0.800(96%CI:0.719~0.882),联合BNP的AUC为0.834(95%CI:0.759~0.909).结论 ARDS患者CC-16水平存在显著增高,且CC-16单独或联合BNP诊断ARDS的临床价值较高.
Abstract
Objective To investigate the serum levels of Clara cell protein-16 (CC-16) in patients with acute respiratory distress syndrome (ARDS), and to explore its clinical value in diagnosis of ARDS.Methods Sixty-two patients with ARDS who were treated in our hospital from October 2011 to February 2016 were enrolled as ARDS froup, and 44 healthy subjects were enrolled as control group.The general situations of patients were recorded,and pulmonary function and arterial blood gas analysis indexes were detected.The levels of CC-16 and BNP were detected by ELISA.The correlation between CC-16 and clinical parameters was analyzed,moreover, the ROC curve was used to evaluate the diagnostic value of CC-16 in patients with ARDS.Results The levels of CC-16 in ARDS group were significantly higher than those in control group [(19.89±8.59) ng/ml vs (11.04±4.77)ng/ml,P<0.01].The levels of CC-16 in patients with different degree of ARDS were in order (from higher levels to lower levels):(24.46±7.58)ng/ml in severe ARDS group,(19.64±7.01)ng/ml in moderate ARDS group and (12.94±6.08)ng/mL in mild ARDS group.Among ARDS group,the levels of CC-16 were positively correlated with APACHEⅡscore (r=0.583,P<0.01),SOFA score (r=0.536,P<0.01),BNP (r=0.427,P<0.01),however,which were negatively correlated to PaO2/FiO2 (r=0.614,P<0.01).The AUC of CC-16 alone in diagnosis of ARDS was 0.800 (95%CI:0.719~0.882),but AUC of CC-16 combined with BNP in diagnosis of ARDS was 0.834 (95%CI: 0.759~0.909).Conclusion The serum levels of CC-16 in patients with ARDS are significantly increased, moreover ,the clinical value of CC-16 alone or CC-16 combined with BNP in diagnosis of ARDS is higher.
关键词
Clara细胞分泌蛋白-16/脑钠肽/急性生理与慢性健康评分Ⅱ/序贯器官衰竭评分Key words
Clara cell protein-16/brain natriuretic peptide/acute physiological and chronic health evaluationⅡscore/sequential organ failure scoring引用本文复制引用
出版年
2017
NETL
NSTL
维普
万方数据