Objective To investigate the expression and clinical value of serum C1q in patients with sepsis compli-cated with acute respiratory distress syndrome(ARDS)of different severity levels.Methods Collect clinical data of 109 pa-tients with sepsis complicated with ARDS from the Intensive Care Department,Respiratory Intensive Care Department,and Infectious Diseases Department of Wuhan University People's Hospital from January 2022 to July 2023,and test laboratory indicators within 24 hours of admission.According to the survival status within 28 days of admission,the patients were di-vided into a survival group of 63 cases and a death group of 46 cases.According to the severity of ARDS,they were divid-ed into a mild group of 32 cases,a moderate group of 38 cases,and a severe group of 39 cases.Compare clinical data and laboratory testing indicators between the death group and the survival group,analyze serum C1q levels in patients with dif-ferent severity levels,and use receiver operating characteristic(ROC)curves to analyze the value of serum C1q levels in pre-dicting the prognosis of sepsis patients with ARDS.Results The age,SOFA score,procalcitonin(PCT),N-terminal proB-NP,urea,blood uric acid,and creatinine of the death group were significantly higher than those of the survival group[Z(t)/P=2.280/0.025,4.241/<0.001,2.031/0.042,2.945/0.003,2.896/0.004,2.068/0.039,2.218/0.027].Pre albumin(PA),total protein(TP),albumin(Alb),PaO2,and oxygenation index(OI)were significantly lower than those of the survival group[Z(t)/P= 2.279/0.023,2.341/0.019,2.700/0.007,4.048/<0.001,6.182/<0.001],and there was a statistically significant difference in the proportion of septic shock between the death group and the survival group(χ2/P=4.718/0.030).The serum C1q levels in the death group were lower than those in the survival group(t/P=4.065/<0.001),and the severe group<moderate group<mild group(F/P=43.494/<0.001).Correlation analysis showed a positive correlation between serum C1q and OI,and a negative correlation with SOFA score(r/P=0.658/<0.001,-0.393/<0.001).Multivariate logistic regression analysis showed that low levels of Alb,C1q,and OI,as well as older age,were independent risk factors for mortality in sepsis complicated with ARDS patients[OR(95%CI)=1.112(1.018-1.213),1.029(1.003-1.055),1.020(1.004-1.036),1.004(0.997-1.010)].The AUC of serum C1q for predicting the prognosis of sepsis patients with ARDS was 0.776,with a 95%CI of 0.689 to 0.862.The cut-off value was 152.25 mg/L,and the sensitivity,specificity,and Jordan index were 0.804,0.619,and 0.423,respectively.Conclu-sion The serum C1q level is closely related to the severity of sepsis complicated with ARDS in patients.Low serum C1q level is an independent risk factor for mortality in sepsis complicated with ARDS,and its detection has certain value for the diagnosis of sepsis complicated with ARDS.
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