血清HSP70、sCD74对脓毒症并发急性呼吸窘迫综合征的预测价值

Value of serum HSP70 and sCD74 in predicting sepsis complicated with acute respiratory distress syn⁃drome

目的探讨血清热休克蛋白70(HSP70)、可溶性CD74(sCD74)和对脓毒症并发急性呼吸窘迫综合征(ARDS)的预测价值。方法选择154例脓毒症患者,其中49例并发ARDS(ARDS组),105例未并发ARDS(NARDS组)。入院后第2天检测血清HSP70、sCD74水平,收集临床资料,分析影响脓毒症并发ARDS的危险因素及HSP70、sCD74、HSP70+sCD74预测脓毒症并发ARDS的价值。结果ARDS组血清HSP70水平低于NARDS组(P<0.001),血清sCD74水平高于NARDS组(P<0.01)。Logistic回归分析结果显示,肺部感染、高APACHEⅡ评分、低水平HSP70和高水平sCD74是脓毒症并发ARDS的危险因素(P均<0.01)。HSP70+sCD74预测脓毒症患者并发ARDS的AUC为0.956,高于单独HSP70、sCD74的0.779、0.762(P均<0.05)。结论脓毒症并发ARDS患者血清HSP70水平降低,sCD74水平升高,低水平HSP70、高水平sCD74与脓毒症患者并发ARDS有关,HSP70、sCD74可作为脓毒症患者并发ARDS的预测指标。

Objective To investigate the value of serum heat shock protein 70(HSP70)and soluble CD74(sCD74)in predicting sepsis complicated with acute respiratory distress syndrome(ARDS).Methods Totally 154 patients with sepsis were selected,including 49 patients complicated with ARDS(ARDS group)and 105 patients without ARDS(NARDS group).The serum HSP70 and SCD74 levels were detected on the 2nd day after admission,and the clinical data were collected.The risk factors for sepsis complicated with ARDS and the value of HSP70,SCD74 and HSP70+SCD74 in predicting ARDS in sepsis were analyzed.Results The level of serum HSP70 in the ARDS group was lower than that in the NARDS group(P<0.01),and the level of serum SCD74 was higher than that in the NARDS group(P<0.01).Logistic regression analysis results showed that lung infection,high APACHEⅡscore,low level of HSP70 and high level sCD74 were risk factors for sepsis complicated with ARDS(all P<0.01).The AUC of HSP70 combined with SCD74 in predicting sepsis patients complicated with ARDS was 0.956,which was higher than 0.779 of HSP70 and 0.762 of SCD74 alone(both P<0.05).Conclusions The level of serum HSP70 in patients with sepsis complicated with ARDS decreases,and SCD74 increases.Low level of HSP70 and high level of SCD74 are related to sepsis complicated with ARDS,and HSP70 and SCD74 can be used as predictors of sepsis complicated with ARDS.