目的 探究血清瓜氨酸组蛋白H3(citrullinated histone H3,CitH3)、降钙素原(procalcitonin,PCT)及白细胞介素-10(interleukin-10,IL-10)对体外心肺复苏(extracorporeal cardiopulmonary resuscitation,ECPR)后急性肺损伤(acute lung injury,ALI)的预测价值.方法 择取2021年1月至2024年4月行ECPR的患者126例,入院次日空腹采血测定患者血清CitH3、PCT、IL-10水平.根据ECPR后ALI发生与否分为ALI组与非ALI组,对比两组临床资料及血清CitH3、PCT、IL-10水平,Logistic多因素回归分析ECPR后ALI发生的危险因素.另外受试者工作特征(receive operating characteristic,ROC)曲线分析血清CitH3、PCT、IL-10对ALI的预测价值.结果 因6例患者未配合完成相关检查等被剔除,最终纳入120例患者,其中住院期间ALI发生28例(ALI组),ALI未发生92例(非ALI组).ALI组入院时急性生理学和慢性健康状况评分(Acute Physiology and Chronic Health Scoring System,APACHE Ⅱ)、序贯器官衰竭评估(Sequential Organ Failure Assessment,SOFA)、心肺复苏到自主循环恢复时间均大于非ALI组(P＜0.05);ALI组血清CitH3、PCT、IL-10水平均高于非ALI组(P＜0.05).Logistic多因素回归分析显示心肺复苏到自主循环恢复时间、血清CitH3、PCT及IL-10是ALI发生的独立危险因素(P＜0.05).ROC曲线显示,血清CitH3、PCT、IL-10单一及3项联合预测ALI发生的曲线下面积(area under curve,AUC)分别为0.886、0.837、0.852、0.951,3项联合的AUC均大于PCT、IL-10单一检测(P＜0.05).结论 ECPR后ALI发生患者血清CitH3、PCT、IL-10水平上升,对ALI发生有一定的预测价值,特别是联合检测效能更显著.
Prognostic Value of Serum CitH3,PCT and IL-10 in Acute Lung Injury after Extracorporeal Cardiopulmonary Resuscitation
Objective To explore the value of serum citrullinated histone H3(CitH3),procalcitonin(PCT),interleukin-10(IL-10)in predicting(Acute Lung Injury)ALI after extracorporeal cardiopulmonary resuscitation(ECPR).Methods A total of 126 patients who underwent ECPR from January 2021 to April 2024 were chosen,and fasting blood samples were collected the next day after admission to determine the levels of serum CitH3,PCT and IL-10.They were separated into the ALI group and the non-ALI group,according to whether ALI occurred after ECPR.Clinical data,serum CitH3,PCT,and IL-10 levels were compared.The risk factors of ALI after ECPR were analyzed by Logistic multivariate regression.The predictive value of serum CitH3,PCT,and IL-10 for ALI was analyzed using receiver operating characteristic(ROC)curve.Results Out of 6 patients,those who did not cooperate to com-plete the relevant examinations were excluded,resulting in 120 patients.During their hospital stay,28 cases of ALI occurred(the ALI group),while 92 cases did not have ALI(the non-ALI group).The ALI group showed higher scores of Acute Physiology and Chronic Health Scoring System(APACH Ⅱ),Sequential Organ Failure Assessment(SOFA),and recovery time from cardiopulmonary resusci-tation to spontaneous circulation(P＜0.05).Serum CitH3,PCT,and IL-10 levels in the ALI group were significantly higher(P＜0.05).Logistic multivariate regression analysis showed that the recovery time from cardiopulmonary resuscitation to spontaneous circulation,serum CitH3,PCT,and IL-10 were independent risk factors for ALI(P＜0.05).The ROC curve analysis revealed that the area under the curve(AUC)for serum CitH3,PCT,and IL-10 individually were 0.886,0.837,and 0.852,respectively.The AUC for the com-bined detection of the three markers was 0.951,which was significantly higher than that of the individual detections of PCT and IL-10(P＜0.05).Conclusions Serum levels of CitH3,PCT,and IL-10 in ALI patients increased after ECPR,indicating a certain predictive value for the occurrence of ALI,with especially notable results when these markers were detected in combination.
万方数据
维普
