感染引发急性肺损伤患者临床预后的影响因素分析

Analysis of Influencing Factors of Clinical Prognosis in Patients with Acute Lung Injury Induced by Infection

目的:研究感染引发急性肺损伤(ALI)患者临床预后的影响因素分析。方法:选取2017年10月-2021年5月大连大学附属中山医院收治的120例感染引发ALI患者,将其按照预后的差异分作死亡组32例及存活组88例。分析两组基线资料,血管紧张素转换酶(ACE)基因多态性情况。以多因素logistic回归分析感染引发ALI患者预后不良的影响因素。比较两组血清白细胞介素-17(IL-17)及白细胞介素-33(IL-33)水平。结果:死亡组ACE基因型为D/D人数占比为68.75%,高于存活组的38.64%,而基因型为I/I型人数占比为9.38%,低于存活组的40.91%(P<0.05)。死亡组年龄和急性生理与慢性健康评分(APACHEⅡ)评分均高于存活组(P<0.05)。多因素logistic回归分析显示,ACE基因型为D/D型、年龄及APACHEⅡ评分均是感染引发ALI患者预后不良的危险因素(P<0.05)。死亡组血清IL-17及IL-33水平均高于存活组(P<0.05)。结论:感染引发ALI患者的临床预后和ACE基因多态性密切相关,且ACE基因型为D/D型患者的预后较差。

Objective:To study and analyze the influencing factors of clinical prognosis in patients with infection-induced acute lung injury(ALI).Method:A total of 120 infection-induced ALI patients admitted to Affiliated Zhongshan Hospital of Dalian University from October 2017 to May 2021 were selected,according to the difference in prognosis,they were divided into 32 cases in the death group and 88 cases in the survival group.The baseline data and angiotensin enzyme(ACE)gene polymorphism of both groups were analyzed.Multivariate logistic regression was used to analyze the influencing factors of poor prognosis in ALI patients induced by infection.The serum interleukin-17(IL-17)and interleukin-33(IL-33)levels were compared between two groups.Result:The proportion of patients with ACE genotype D/D in death group was 68.75%,which was higher than 38.64%in survival group,while the proportion of patients with ACE genotype I/I in death group was 9.38%,which was lower than 40.91%in survival group(P<0.05).The age and acute physiology and chronic health evaluation(APACHEⅡ)score in death group were higher than those in survival group(P<0.05).Multivariate logistic regression analysis showed that D/D ACE genotype,age and APACHEⅡscore were risk factors for poor prognosis in patients with infection-induced ALI(P<0.05).The levels of IL-17 and IL-33 in death group were higher than those in survival group(P<0.05).Conclusion:The clinical prognosis of infection-induced ALI patients is closely related to ACE gene polymorphism,and the prognosis of patients with ACE genotype D/D is poor.