可溶性晚期RAGE水平与重型颅脑损伤继发急性肺损伤的相关分析

Analysis on Relationship between Plasma Soluble Receptor for Advanced Glycation End Products Concentrations and Acute Lung Injury Secondary to Severe Traumatic Brain Injury

目的揭示血浆可溶性晚期糖基化终末产物受体（receptor for advanced glycation end products,RAGE）水平对重型颅脑损伤（severe traumatic brain injury,STBI）继发急性肺损伤（acute lung injury,ALI）的预测价值。方法收集102例STBI患者和50例健康体检者（对照组）,采用ELISA法检测血浆可溶性RAGE水平,统计分析血浆可溶性RAGE水平的变化及对STBI继发ALI的预测价值。结果 STBI患者血浆可溶性RAGE水平[（1075.31±420.92）pg/ml]较对照组[（860.01±244.13）pg/ml]显著增高,差异有统计学意义（P〈0.01）。血浆可溶性RAGE水平〉1197.23pg/ml预测STBI继发ALI有72.41%的灵敏度和80.82%的特异度。同时,血浆可溶性RAGE水平〉1197.23pg/ml可独立预测STBI继发ALI（OR=11.40,95%CI=2.33-54.10,P〈0.05）。结论血浆可溶性RAGE水平可协助临床预测STBI并发ALI。

Objective To investigate the clinical significance of plasma soluble receptor for advanced glycation end products（ RAGE）concentrations in acute lung injury（ ALI） secondary to severe traumatic brain injury（ STBI）. Methods A total of 102 STBI patients and50 healthy individuals（ control group） were recruited. Enzyme-linked immunosorbent assay（ ELISA） was carried out to measure soluble RAGE concentrations in plasma. Corresponding statistical methods were performed to explore the change of plasma soluble RAGE concentrations and its predictive performance for ALI following STBI. Results Plasma soluble RAGE concentrations were significantly higher（ t =3. 98,P〈0. 01） in STBI patients（ 1075. 31 ±420. 92pg/ml） than in controls（ 860. 01 ±244. 13pg/ml）. Plasma soluble RAGE concentrations could significantly predict ALI secondary to STBI（ area under curve =0. 814,95% CI =0. 73 -0. 88,P〈0. 01）,and its concentration 1197. 23 pg / ml predicted secondary ALI after STBI with sensitivity of 72. 41% and specificity of 80. 82%. Meanwhile,its concentration 1197. 23 pg / ml（ OR =11. 40,95% CI =2. 33 - 54. 10,P〈0. 05） could independently predict STBI-induced ALI. Conclusions Plasma soluble RAGE concentration has high clinical value for predicting ALI induced by STBI.