[1]温占兵.血管生成素-1水平变化预测脓毒症急性肺损伤的价值[J].医学信息,2018,31(13):95-97.[doi:10.3969/j.issn.1006-1959.2018.13.027]
　WEN Zhan-bing.The Value of Angiopoietin-1 Level Change in Predicting Acute Lung Injury in Sepsis[J].Journal of Medical Information,2018,31(13):95-97.[doi:10.3969/j.issn.1006-1959.2018.13.027]
点击复制

血管生成素-1水平变化预测脓毒症急性肺损伤的价值()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
31卷
期数:
2018年13期
页码:
95-97
栏目:
论著
出版日期:
2018-07-01

文章信息/Info

Title:
The Value of Angiopoietin-1 Level Change in Predicting Acute Lung Injury in Sepsis
文章编号:
1006-1959（2018）13-0095-04
作者:
温占兵
天津市人民医院急诊科，天津 300121
Author(s):
WEN Zhan-bing
Department of Emergency,Tianjin People's Hospital,Tianjin 300121,China
关键词:
血管生成素-1; 血管外肺水指数; 脓毒症; 急性肺损伤
Keywords:
Key words：Angiopoietin-1; Extravascular lung water index; Sepsis; Acute lung injury
分类号:
R459.7
DOI:
10.3969/j.issn.1006-1959.2018.13.027
文献标志码:
A
摘要:
目的 探讨血管生成素-1动态变化预测脓毒症急性肺损伤形成的价值。方法 选取2016年6月~2017年6月收入我院ICU行PICCO监测的脓毒症患者43例，按照血管外肺水指数分为损伤组16例和非损伤组27例，选择健康体检者20例为对照组。所有患者入院时及入院后第1、2、3天早晨抽取静脉血离心后取血清，采用酶联免疫吸附法检测Ang-1血清水平，同时测量对应的EVLWI值。比较两组间Ang-1水平的差异，运用接收者工作特征曲线下面积检测Ang-1水平变化差值的预测效力。结果 与对照组比较，脓毒症患者发病后血清Ang-1水平升高，差异具有统计学意义（P＜0.05）；损伤组与非损伤组比较，第3天与入院时血清Ang-1水平的差值升高，差异具有统计学意义（P＜0.05），第1、2天与入院时血清Ang-1水平差值两组间比较，差异无统计学意义（P＞0.05）；第3天与入院时血清Ang-1水平差值预测肺损伤的曲线下面积为0.759（P＜0.01，95%CI：0.565~0.905），最佳截断点为6.5 ng/ml。结论 发病后第3天明显升高的Ang-1对判断脓毒症肺损伤的形成有一定的临床价值。
Abstract:
Abstract：Objective To investigate the value of angiopoietin-1 dynamic changes in predicting the formation of acute lung injury in sepsis.Methods From June 2016 to June 2017,43 patients with sepsis who were monitored by PICCO in our hospital ICU were enrolled.According to the extravascular lung water index,16 patients were included in the injury group and 27 patients were in the non-injury group.20 healthy subjects were selected as the control group.All patients were enrolled in the venous blood at the time of admission and on the morning of the first,second,and third days after admission.The serum level of Ang-1 was detected by enzyme-linked immunosorbent assay,and the corresponding EVLWI value was measured.The difference in Ang-1 levels between the two groups was compared,and the predictive power of the difference in Ang-1 levels was measured using the area under the receiver operating characteristic curve.Results Compared with the control group,the serum Ang-1 level increased after the onset of sepsis,the difference was statistically significant(P<0.05);The difference of the serum Ang-1 level between the third days and the admission was higher in the injury group than in the non injury group,and the difference was statistically significant(P<0.05).The difference between the first,second days and the level of serum Ang-1 level between the two groups was not statistically significant(P>0.05),the difference in serum Ang-1 levels on day 3 and admission was predicted to be 0.759 (P<0.01,95%CI:0.565 to 0.905)and the best cut-off point was 6.5 ng/ml.Conclusion Ang-1,which is significantly elevated on the third day after onset,has certain clinical value in judging the formation of lung injury in sepsis.

参考文献/References:

[1]Redwan B,Ziegeler S,Freermann S,et al.Single-site low-flow veno-venous xtracorporeal lung support does not influence hemodynamic monitoring by transpulmonary thermodilution[J].ASAIO J,2016,62(4):454-457. [2]朱金伟.脓毒症患者出现肺损伤与微量白蛋白尿的相关性研究[J].临床肺科杂志,2017,22(4):699-701. [3]Mitra A,Yadav A,Mehta N,et al.Complicated perianal sepsis[J].Indian J Surg,2015,77(3):769-773. [4]Parikh SM,Mammoto T,Schultz A,et al.Excess circulating angiopoietin-2 may contribute to pulmonary vascular leak in sepsis in humans[J].PLOS Med,2006,17(5):1207-1214. [5]Levy MM,Fink MP,Marshall JC,et al.2001 SCCM ESICM ACCP ATS SIS International Sepsis Definitions Conference[J].Intensive Care Med,2014,29(4):530-536. [6]卢海源,史国辉,佟苏东,等.脓毒症致全身各系统发病机制及治疗的研究[J].医学信息,2013,26(5):646-647. [7]Philipp K,Matijs M,Sascha D,et al.Time course of angiopoietin-2 release during experimental human endotoxemia and sepsis[J].Critical Care,2009,13(3):1-5. [8]邓宁,常为民,王春全,等.急性呼吸窘迫综合征患者血管外肺水的动态变化与预后的关系[J].中国呼吸与危重监护杂志,2012,11(6):528-535. [9]Heijden VD,Amerongen VN,Koolwijk P,et al.Angiopoietin-2,permeability oedema,occurrence and severity of ALIARDS in septic and non-septic critically ill patients[J].Thorax,2008,63(10):903-910.

更新日期/Last Update: 2018-07-01