A型主动脉夹层术后急性呼吸窘迫综合征与炎性蛋白可溶性晚期糖基化终末产物受体、钙结合蛋白A12的关系

Relationship between inflammatory proteins soluble receptor for advanced glycation end products and calcium binding protein A12 with the onset of postoperative acute respiratory distress syndrome in the patients with type A aortic dissection

目的观察A型主动脉夹层患者血浆中可溶性晚期糖基化终末产物受体（sRAGE）及其配体钙结合蛋白A1（S100A12）围术期的动态变化。方法患者分为急性呼吸窘迫综合征组（ARDS组，n=8），以及未发生急性呼吸窘迫综合征组（non—ARDS组，n=13）。采用酶联免疫吸附试验（ELISA）检测血浆sRAGE、S100A12、白细胞介素（IL）-6浓度并进行矫正，即可溶性晚期糖基化终末产物受体矫正浓度（sRAGEN）、钙结合蛋白A1矫正浓度（S100A12N）、白细胞介素-6矫正浓度（IL-6）。结果两组患者血浆sRAGEN、S100A12N、IL-6N在体外循环（CPB）结束时均明显升高，之后逐渐下降，分别于术后24、72、24h降至术前水平，但术后24h以内ARDS组均高于non—ARDS组。术前、CPB结束、术后24h浓度分别为sRAGEN：（1．98±0．47）ng／g比（1．59±0．32）ng／g，（9．66±1．98）ng／g比（7．01±2．18）ng,／g，（2．87±0．72）ns／g比（1．93±0．52）ng/g；S100A12N：（0．06±0.02）μg/g比（0．05±0．01）μg／g，（0．19±0．08）μg／g比（0．16±0．04）μg／g，（0．10±0．03）μg／g比（0．09±0．02）μg／g；IL-6N：（1．57±0．35）ng／g比（1．08±0．41）ng／g，（12．19±2．16）ng／g比（7．04±1．89）ng/g，（2．32±0．92）ng／g比（1．42±0．75）ng／g（P〈0．05）。sRAGEN、S100A12N与术后早期最低氧和指数呈线性负相关，与术后机械通气时间呈线性正相关。结论sRAGE、S100A12升高与主动脉夹层患者术后ARDS明显相关。

Objective To observe perioperative dynamic changes of the plasma soluble receptor tor advanced glycation end products （sRAGE） and calcium binding protein A12 （S100A12） in patients with type A aortic dissection. Methods Twenty - one patients with type A aortic dissection undergoing surgery were divided into acute respiratory distress syndrome （ARDS） group （n = 8） and non -ARDS group （n=13）. The plasma concentration of sRAGE, S100A12 and interleukin （IL） -6 was detected by enzyme linked immunosorbent assay （ELISA） and calibrated with serum total protein, which was shown as sRAGEN, S100AI2N and IL -6N. Results Although sRAGEN, S100A12N and IL -6N in both groups increased dramatically at the end of CPB and then decreased gradually, they were higher in ARDS group than in non - ARDS group within 24 h after operation, which were sRAGEN ： sRAGEN ： （ 1.98 ±0. 47 ） ng/g vs. （1.59 ±0.32） ng/g, （9.66±1.98） ng/gvs. （7.01 ±2. 18） ng/g, （2. 87 ±0.72） ng/gvs. （1.93±0.52） ng/g; S100A12N： （0.06 ±0.02） μg/g vs. （0.05 ±0.01） μg/g, （0. 19 ±0.08） μg/g vs.（0.16±0.04） μg/g, （0.10±0.03） μg/gvs. （0.09 ±0.02） μg/g; IL-6N ： （1. 57 ±0. 35 ） ng/gvs. （1.08 ±0.41） ng/g, （12. 19 ±2. 16） ng/g vs. （7.04 ±1.89） ng/g,（2. 32 ±0.92） ng/g vs. （1.42 ±0. 75） ng/g, preoperative, at the end of CPB, 24 h after operation, respectively （P 〈 0. 05 ）. sRAGEN, S100A12N at end of CPB were negative linearly correlated with the minimum oxygenation index within 2 days after operation, and positive linearly correlated with duration of mechanical ventilation. Coneluslon The increase of sRAGE and S100A12 was significantly correlated to the onset of postoperative ARDS in the patients with type A aortic dissection.