急性呼吸窘迫综合征患者血清sTM水平变化及对预后的预测价值

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Abstract Objective To study the changes of serum soluble thrombomodulin (sTM) levels and its prognostic value in patients with acute respiratory distress syndrome (ARDS). Methods A total of 96 patients with ARDS admitted to Wuhan Third Hospital from December 2018 to December 2019 were selected as the observation group, they were divided into mild group (25 cases) and moderate group (53 cases) and severe group (18 cases) according to the oxygenation index (OI). Patients were divided into survival group (46 cases) and death group (50 cases) according to their survival status after 28 days. Another 48 healthy persons who were admitted to the hospital during the same period were selected as the control group. The difference in serum sTM level and acute physiology and chronic health score Ⅱ (APACHE Ⅱ) between the observation group and the control group, ARDS patients of different degrees, and different outcome groups were compared, while the correlation between serum sTM level and APACHE Ⅱ score were analyzed. ROC survival curve was drew and to analyze the predictive value of serum sTM level and APACHE Ⅱ score on the prognosis of ARDS patients. Results The serum sTM level and APACHE Ⅱ score of the observation group were higher than those of the control group, and the differences were statistically significant (P ＜ 0.05). Comparison of serum sTM levels and APACHE Ⅱ scores of ARDS patients in different degree groups showed statistically significant differences (P ＜ 0.05), and the levels of indexes in the severe group were higher than those in the moderate and mild groups, while the levels in the moderate group were higher than those in the mild group, and the differences were statistically significant (P ＜ 0.05). Serum sTM level was positively correlated with APACHE Ⅱ score (r = 0.691, P ＜ 0.05). The serum sTM level and APACHE Ⅱ score of the survival group were significantly lower than those of the death group, and the differences were statistically significant (P ＜ 0.05). ROC curve results showed that the predictive power of serum sTM level on the prognosis of ARDS patients was higher than the APACHE Ⅱ score (P ＜ 0.05). Conclusion sTM may be involved in the progression of ARDS, and its level changes can be used as an early biomarker to judge the severity and prognosis of ARDS patients.

Key words： Acute respiratory distress syndrome Soluble thrombomodulin Prognosis Changes

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	CHEN Wenwen1 YE Siying2 CHEN Guilan2

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CHEN Wenwen1 YE Siying2 CHEN Guilan2. Changes of serum sTM levels and its prognostic value in patients with acute respiratory distress syndrome[J]. 中国医药导报, 2021, 18(2): 16-19.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2021/V18/I2/16

[1] 刘婷，赵德育.活性氧作用于急性肺损伤/急性呼吸窘迫综合征的研究进展[J].国际呼吸杂志，2019，39（24）：1890-1894.
[2] 江浩，郑贸根，朱超男，等.APACHE Ⅱ、ISS、SOFA评分对创伤继发ARDS严重程度及预后的预测价值比较[J].临床肺科杂志，2018，23（11）：2074-2078.
[3] 金曌，付霆，苏慧，等.血浆组织因子途径抑制物和可溶性血栓调节蛋白的变化对过敏性紫癜患者的影响及意义[J].解放军预防医学杂志，2019，37（9）：160-161，163.
[4] 刘丹丹，张洪钿，孙月，等.血清ACA、sTM及Copeptin水平对脑梗死患者神经功能缺损程度的评估价值[J].山东医药，2020，60（1）：68-70.
[5] 白驹，杨力芳.结直肠癌患者血浆中可溶性血栓调节蛋白的水平及其临床意义[J].分子诊断与治疗杂志，2018， 10（1）：38-42.
[6] Ranieri VM，Rubenfeld GD，Thompson BT，et al. Acute respiratory distress syndrome：the Berlin Definition [J]. JAMA，2012，307（23）：2526-2533.
[7] 苏坤，邹外龙，朱卫华，等.血清N末端B型脑钠肽前体、降钙素原在急性呼吸窘迫综合征中的临床应用价值[J].临床肺科杂志，2018，23（1）：96-99.
[8] Lee JH，Hwang SY，Kim HR，et al. Effectiveness of the sequential organ failure assessment，acute physiology and chronic health evaluation Ⅱ，and simplified and physiology score Ⅱ prognostic scoring systems in paraquat-poisoned patients in the intensive care unit [J]. Hum Exp Toxicol，2017，36（5）：431-437.
[9] 刘盈秀，杜隽铭.急性呼吸窘迫综合征的治疗进展[J].浙江学，2019，41（17）：1901-1903，1908.
[10] 解冰洁，李爱民.急性呼吸窘迫综合征与弥漫性肺泡损伤关系的新认识[J].国际呼吸杂志，2020，40（3）：225-228.
[11] Forel JM，Guervilly C，Farnarier C，et al. Transforming growth factor-betal in predicting early lung fibroproliferation in patients with acute respiratory distress syndrome [J]. Plos One，2018，13（11）：e206105.
[12] 刘荔龙.肺损伤超声评分在急性呼吸窘迫综合征患者中的临床应用[J].中外医疗，2019，38（31）：187-189.
[13] 刘明双，彭芳，杨昆，等.脓毒症患者血清PCT水平与APACHE Ⅱ、SOFA评分相关性及其预后评估[J].中外医学研究，2018，16（2）：28-30.
[14] 章文豪，王翔，孙芳，等.急性呼吸窘迫综合征患者乳酸清除率及APACHEⅡ评分的动态变化及临床意义[J].中外医学研究，2020，18（1）：13-15.
[15] 柴云飞，雷黎明，李鹏，等.血管内皮细胞损伤与脓毒症休克的相关性[J].实用医学杂志，2017，33（15）：2529-2532.
[16] 王妙淑.脓毒症患者血清可溶性血栓调节蛋白与预后的相关性[J].实用医学杂志，2019，35（9）：1462-1464.
[17] Sapru A，Calfee CS，Liu KD，et al. Plasma soluble thrombomodulin levels are associated with mortality in the acute respiratory distress syndrome [J]. Intensive Care Med，2015，41（3）：470-478.
[18] 成亚东，刘辉，崔琛，等.急性呼吸窘迫综合征患者血清Clara细胞分泌蛋白16及单核细胞趋化蛋白1水平与病情严重程度和预后的关系[J].中国综合临床，2019， 35（4）：290-295.
[19] 刘婷，赵德育.活性氧作用于急性肺损伤/急性呼吸窘迫综合征的研究进展[J].国际呼吸杂志，2019，39（24）：1890-1894.
[20] Levi M，Van Der Poll T. Endothelia injury in sepsis [J]. Intensive Care Med，2013，39（10）：1839-1842.
[21] 郭丽，纪红，邹外龙，等.老年急性呼吸窘迫综合征患者血清可溶性血栓调节蛋白水平变化及临床意义[J].中华实用诊断与治疗杂志，2019，33（10）：994-997.