Changes of Alveolar Macrophage Phagocytosis Function in ARDS Patients and Its Predictive Analysis of Poor Prognosis
Objective To observe the changes of alveolar macrophage(AM)phagocytosis in patients with acute respiratory distress syndrome(ARDS),and to analyze its predictive value for poor prognosis of ARDS.Methods A total of 248 patients with ARDS admitted to our hospital from January 2020 to January 2023 were selected as the research objects,and the AM phagocytosis function(including neutral red phagocytosis ability and acid phosphatase activity)was detected.According to the survival of patients within 28 days after admission,they were divided into poor prognosis group(81 cases)and good prognosis group(167 cases),and the AM phagocytosis function of the two groups was compared.Multivariate Logistic regression was used to analyze the influencing factors of poor prognosis in ARDS patients,and the receiver operating characteristic curve(ROC)was used to analyze the predictive value of AM phagocytic function for poor prognosis in patients with ARDS.Results The acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,sequential organ failure assessment(SOFA)score,urea nitrogen and the proportion of severe Berlin index in the poor prognosis group were higher than those in the good prognosis group(P＜0.05),and albumin(Alb),oxygenation index,neutral red phagocytosis and acid phosphatase activity were lower than those in the good prognosis group(P＜0.05).Multivariate Logistic regression analysis showed that the decreased of APACHE Ⅱ score and SOFA score,and severe Berlin index were risk factors for poor prognosis of ARDS patients(P＜0.05),and the increased of Alb,oxygenation index,neutral red phagocytosis and acid phosphatase activity were protective factors(P＜0.05).ROC results showed that the sensitivity and AUC of neutral red phagocytosis and acid phosphatase activity in predicting the poor prognosis of ARDS were 91.36％and 0.927,respectively,which were higher than those predicted alone(P＜0.05).and there was no significant difference in specificity between combined prediction and single prediction(P＞0.05).Conclusion AM neutral red ability and acid phosphatase activity in ARDS patients are influencing factors for poor prognosis in ARDS patients,and have good predictive value for poor prognosis in ARDS patients.
A cute Respiratory Distress SyndromeAlveoliMacrophagesPhagocytic FunctionPoor PrognosisPredictive Value
万方数据
维普
