急性呼吸窘迫综合征患者血清可溶性CD74水平变化及意义

Change and significance of serum soluble CD74 in patients with acute respiratory distress syndrome

目的观察急性呼吸窘迫综合征患者血清可溶性CD74(s CD74)水平变化,并探讨其临床意义。方法呼吸窘迫综合征患者93例作为观察组,根据氧合指数将患者分为轻度组20例、中度组42例、重度组31例;同期体检健康者50例作为对照组。检测各组血清s CD74、白细胞介素6(IL-6)、IL-10、IL-13,分析各组以上指标的变化,用Pearson相关分析各指标相关关系;绘制受试者工作特征(ROC)曲线,用ROC曲线下面积(AUC)分析指标的诊断价值。结果观察组血清s CD740、IL-6、IL-10、IL-13水平均高于对照组(P均<0. 05)。轻、中、重度组血清s CD74、IL-6、IL-10、IL-13水平比较差异有统计学意义(P均<0. 05)。趋势检验结果显示血清s CD74、IL-6、IL-10、IL-13水平均随病情由轻到重呈现线性增加趋势(P均<0. 05)。观察组血清s CD74水平与IL-6、IL-10、IL-13均呈正相关(r分别为0. 643、0. 618、0. 604,P均<0. 05)。血清s CD74诊断急性呼吸窘迫综合征的AUC最大,均高于其他指标(P均<0. 05),且血清s CD74、IL-6、IL-10、IL-13联合检测诊断急性呼吸窘迫综合征的AUC亦高于上述各项指标单独检测(P均<0. 05)。结论急性呼吸窘迫综合征患者血清s CD74水平升高;与血清s CD74、IL-6、IL-10、IL-13联合检测可对急性呼吸窘迫综合征患者病情严重程度进行评估。

Objective To observe the change of serum soluble CD74(sCD74)in patients with acute respiratory distress syndrome and to explore its clinical significance.Methods Ninety-three patients with respiratory distress syndrome were selected as the observation group,according to the oxygenation index,the patients were divided into the mild group(n=20),moderate group(n=42)and severe group(n=31),meanwhile,50 healthy persons in the same period were taken as the control group.The serum sCD74,interleukin 6(IL-6),IL-10,and IL-13 were detected in each group.The change of the above indexes in each group was analyzed,and the correlation of each index was analyzed by Pearson correlation analysis.The receiver operating characteristic(ROC)curve was plotted,and the area under the ROC curve(AUC)was used to analyze the diagnostic value of these indexes.Results The levels of serum sCD740,IL-6,IL-10,and IL-13 in the observation group were higher than those in the control group(all P<0.05).There were significant differences in serum level of sCD74,IL-6,IL-10 and IL-13 among the mild,moderate and severe groups(all P<0.05).Trend test showed that the serum levels of sCD74,IL-6,IL-10,and IL-13 increased linearly with the severity of the disease(all P<0.05).Serum sCD74 level was positively correlated with IL-6,IL-10,and IL-13 in the observation group(r=0.643,0.618,0.604 respectively;all P<0.05).The AUC of serum sCD74 in the diagnosis of acute respiratory distress syndrome was the largest,higher than that of the other indicators(all P<0.05),and the combined detection of serum sCD74,IL-6,IL-10 and IL-13 in diagnosis of AUC in patients with acute respiratory distress syndrome was also higher than the above indicators alone(all P<0.05).Conclusion Serum sCD74 level in patients with acute respiratory distress syndrome is elevated,and the combined detection of serum sCD74,IL-6,IL-10,and IL-13 can evaluate the severity of acute respiratory distress syndrome.