【摘要】 目的探讨血清脂多糖结合蛋白(LBP)、热休克蛋白70(HSP70)、诱捕受体3(DcR3)水平预测急性呼吸窘迫综合征(ARDS)患者病情转归的价值。方法选取本院2017年5月至2019年5月收治的92例ARDS患者作为研究对象,根据30 d预后情况选取存活患者64例为生存组,全因死亡患者28例为死亡组。对比分析两组血清LBP、HSP70、DcR3水平、序贯器官衰竭估计(SOFA)评分、急性生理与慢性健康Ⅱ(APACHEⅡ)评分及相关性,探讨其预后预后预测价值。结果死亡组入院时、入院第7天血清LBP、DcR3水平高于生存组,HSP70水平低于生存组,SOFA、APACHEⅡ评分高于生存组(P<0.05),且生存组入院时与入院第7天差值高于死亡组(P<0.05);血清LBP、DcR3水平与SOFA、APACHEⅡ评分呈正相关,HSP70与SOFA、APACHEⅡ评分呈负相关(P<0.05);入院第7天HSP70 AUC(0.830)>入院第7天LBP(0.806)>入院第7天DcR3(0.766);血清LBP、HSP70、DcR3高危组、低危组生存曲线对比,差异有统计学意义(P<0.05)。结论血清LBP、HSP70、DcR3水平与ARDS患者病情严重程度密切相关,有望成为评估ARDS预后的主要预测因子。更多还原

【Abstract】 Objective To investigate the value of serum lipopolysaccharide binding protein(LBP),heat shock protein 70(HSP70)and trap receptor 3(DcR3)levels in predicting the outcome of patients with acute respiratory distress syndrome(ARDS). Methods 92 patients with ARDS admitted to our hospital from May 2017 to May 2019 were recruited as the research object. According to the prognosis of 30 days,64 surviving patients were selected as the survival group,and 28 patients with all-cause death were the death group. The serum levels of LBP,HSP70,DcR3,sequential organ failure assessment(sofa),acute physiology and chronic health Ⅱ(APACHE Ⅱ)were compared between the two groups. Results The serum LBP and DcR3 levels were higher in the death group on the day of admission and the 7 th day after admission than those in the survival group. HSP70 level was lower than that in the survival group. SOFA and APACHE II scores were higher than in the survival group(P<0.05). The difference inthe survival group and the seventh day after admission was significant compared to the death group(P<0.05). The Serum LBP and DcR3 levels were positively correlated with SOFA and APACHEⅡ scores,and HSP70 was negatively correlated with SOFA and APACHE Ⅱ scores(P<0.05). Seventh day after admission,HSP70 AUC(0.830)>LBP(0.806) >DcR3(0.766). There were significant differences in the survival curves of serum LBP,HSP70,and DcR3 between the high-risk groups and the low-risk groups(P<0.05). Conclusion Serum LBP,HSP70,and DcR3 levels are closely related to the severity of ARDS patients,and are expected to be the main predictors of ARDS prognosis.更多还原