血清克拉拉细胞蛋白16及可溶性晚期糖基化终末产物受体联合用于ARDS诊断及死亡风险预测临床价值研究

Clinical value of serum CC 16 combined with soluble RAGE in diagnosis and death risk prediction of ARDS

目的探讨血清克拉拉细胞蛋白16(CC16)及可溶性晚期糖基化终末产物受体(RAGE)联合用于急性呼吸窘迫综合征(ARDS)诊断及死亡风险预测临床价值。方法本次研究纳入2018年1月至2021年5月邯郸市第一医院重症加强护理病房(ICU)收治ARDS患者107例和非ARDS患者110例,并根据ARDS患者住院期间是否死亡分组,其中死亡组40例,存活组67例;分析一般资料、血清CC16及可溶性RAGE水平,描绘受试者工作特征(ROC)曲线评价两种生物标志物指标单用及联用于ARDS诊断及死亡风险预测效能。结果ARDS组机械通气时间、住院期间死亡率、血清CC16及可溶性RAGE水平分别为(16.01±3.65)d,37.38%(40/107),(45.84±9.35)mg/L,(2785.35±310.22)pg/L,均高于存活组[(12.94±3.02)d,10.00%(11/110),(31.80±7.38)mg/L,(2261.33±160.21)pg/L](P<0.05);ARDS住院期间死亡组急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、血清CC16及可溶性RAGE水平分别为(24.09±3.43)分,(43.39±10.66)mg/L,(2659.07±249.13)pg/L,均高于存活组[(19.82±2.74)分,(31.01±8.50)mg/L,(2283.89±208.42)pg/L](P<0.05);ROC曲线分析结果显示,血清CC16联合可溶性RAGE用于ARDS诊断及死亡风险预测临床效能优于两者单用(P<0.05)。结论血清CC16及可溶性RAGE均可辅助用于ARDS诊断及死亡风险预测,且两者联合效能更佳。

【Objective】To investigate the clinical value of serum CC16 combined with soluble RAGE in diagnosis and death risk prediction of ARDS.【Methods】A total of 107 ICU patients with ARDS and 110 ICU patients without ARDS were chosen in the period from January 2018 to May 2021 in our hospital and ARDS patients were grouped according to whether died during hospitalization or not.The general data,serum CC16 and soluble RAGE levels were analyzed.The ROC curve was drawn to evaluated the efficacy of serum CC16 and soluble RAGE in the diagnosis and death risk prediction of ARDS.【Results】The mechanical ventilation time,mortality during hospitalization,serum CC16 and soluble RAGE levels in ARDS group separately for 16.01±3.65 d,37.38%(40/107),45.84±9.35 mg/L,2785.35±310.22 pg/L were significantly higher than survival group separately for 12.94±3.02 d,10.00%(11/110),31.80±7.38 mg/L,2261.33±160.21 pg/L(P<0.05).The APAHE II score,serum CC16 and soluble RAGE levels in death group during ARDS hospitalization separately for 24.09±3.43 points,43.39±10.66 mg/L,2659.07±249.13 pg/L were significantly higher than survival group separately for 19.82±2.74 points,31.01±8.50 mg/L,2283.89±208.42 pg/L(P<0.05).ROC curve analysis showed that the clinical efficacy of serum CC16 combined with soluble RAGE in ARDS diagnosis and death risk prediction was better than each alone(P<0.05).【Conclusion】Serum CC16 and soluble RAGE can be used in the diagnosis and death risk prediction of ARDS,and joint detection has better efficacy.