sRAGE与重症肺炎患者病情程度、应激性高血糖的关系

Correlation of serum sRAGE with severity degree and stress hyperglycemia in severe pneumonia patients

目的探讨血清可溶性晚期糖基化终末产物受体(sRAGE)水平与重症肺炎患者病情严重程度和应激性高血糖发生的关系。方法选取2016年6月—2019年5月在马鞍山市人民医院重症医学科住院治疗的成人非糖尿病重症肺炎患者100例、普通肺炎患者100例,以及同期该院健康体检者100例。检测血清sRAGE、晚期糖基化终末产物(AGEs)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)水平。检测重症肺炎患者空腹血糖,并分为合并应激性高血糖(空腹血糖≥7.0 mmol/L)(合并组)和未合并应激性高血糖患者(空腹血糖<7.0 mmol/L)(未合并组)。比较两组患者血清sRAGE水平,采用多元线性回归对sRAGE的影响因素进行分析。结果重症肺炎患者血清sRAGE水平高于健康对照和普通肺炎患者(P<0.05)。合并组血清sRAGE水平高于未合并组(P<0.05)。APACHEⅡ评分[OR=2.295(95%CI:1.877,3.241)]、MODS评分[OR=3.315(95%CI:2.186,5.673)]、sRAGE[OR=1.271(95%CI:1.026,1.573)]、AGEs[OR=1.328(95%CI:1.105,1.792)]是重症肺炎患者发生应激性高血糖的独立影响因素(P<0.05)。结论血清sRAGE在重症肺炎患者尤其是发生应激性高血糖的重症肺炎患者中的表达水平明显升高,sRAGE不仅可反映肺炎患者的疾病严重程度,而且参与应激性高血糖的发生过程。

Objective To investigate the correlation of serum soluble receptor for advanced glycation end products(sRAGE)with severity degree and stress hyperglycemia in severe pneumonia patients.Methods From 2016.06 to 2019.05,100 patients with severe pneumonia,100 patients with pneumonia and 100 healthy cases in our hospital were enrolled into the study.The serum sRAGE,tumor necrosisα(TNF-α),interleukin-6(IL-6),hypersensitivity C reactive protein(hs-CRP),advanced glycation end products(AGEs)levels of all subjects were detected and compared.According to the fasting plasma glucose(FPG),100 patients with severe pneumonia were divided into stress hyperglycemia group(FPG≥7.0 mmol/L)and non-stress hyperglycemia group(FPG<7.0 mmol/L).Unvariate and multivariate linear regression analysis were used to analyze the influence factors of sRAGE in severe pneumonia patients.Results The serum sRAGE levels in severe pneumonia patients were higher than healthy cases and pneumonia patients(P<0.05).And the serum sRAGE levels in stress hyperglycemia group were higher than that in non-stress hyperglycemia group(P<0.05).Multivariate regression model analysis showed APACHEⅡscore[OR=2.295(95%CI:1.877,3.241)],MODS score[OR=3.315(95%CI:2.186,5.673)],serum AGEs(OR=1.271(95%CI:1.026,1.573)],serum sRAGE[OR=1.328(95%CI:1.105,1.792)]were the independent influence factors of stress hyperglycemia in severe pneumonia patients(P<0.05).Conclusions The serum sRAGE levels in severe pneumonia patients increase,especially in stress hyperglycemia patients,which could reflect the severity degree of pneumonia and stress hyperglycemia.