涎液化糖链抗原-6与Standford A型主动脉夹层患者发生急性肺损伤的关系

Relationship between Krebs von den Lungen-6 and acute lung injury in patients with Standford aortic type A dissection

目的探讨血清涎液化糖链抗原-6(KL-6)与Standford A型主动脉夹层患者发生急性肺损伤的关系。方法选取2019年5月―2021年5月十堰市太和医院确诊的Standford A型主动脉夹层患者78例,根据静态吸氧时氧合指数将患者分为肺损伤组(30例)和非肺损伤组(48例)。收集所有患者的临床资料和相关检查结果。检测所有患者术前12 h(T1)、麻醉诱导后(T2)、手术结束(T3)、术后12 h(T4)的血清KL-6水平。采用逐步Logistic回归分析评估Standford A型主动脉夹层患者发生急性肺损伤的危险因素。采用Pearson相关分析评估各项指标之间的相关性。结果肺损伤组各时间点血清KL-6水平均显著高于非肺损伤组(P<0.001)。肺损伤组和非肺损伤组T3、T4时间点血清KL-6水平均高于T1、T2时间点(P<0.05)。肺损伤组与非肺损伤组之间夹层分期(急性期)例数、累及肠系膜上动脉例数和白细胞(WBC)计数、高敏C反应蛋白(hs-CRP)、KL-6水平差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,hs-CRP和KL-6是Standford A型主动脉夹层患者发生急性肺损伤的独立危险因素[比值比(OR)分别为2.063、2.555,95%可信区间(CI)分别为1.104~3.854、1.272~5.133]。Pearson相关分析结果显示,KL-6、hs-CRP与氧合指数均呈负相关(r值分别为-0.561、-0.368,P<0.01)。结论血清KL-6水平与Standford A型主动脉夹层患者发生急性肺损伤密切相关。

Objective To investigate the relationship between serum Krebs von den Lungen-6(KL-6)and acute lung injury in Standford aortic type A dissection.Methods A total of 78 patients in Taihe Hospital of Shiyan from May 2019 to May 2021 were diagnosed as Standford aortic type A dissection.According to the oxygenation index during static oxygen inhalation,the patients were classified into lung injury group(30 cases)and non-lung injury group(48 cases).The clinical data and laboratory determination results of all the patients were collected,and serum KL-6 levels were determined at 12 h before surgery(T1),after induction of anesthesia(T2),after surgery(T3)and 12 h after surgery(T4).Stepwise Logistic regression analysis was used to assess the risk factors for acute lung injury in Standford aortic type A dissection.Pearson correlation analysis was used to evaluate the correlation among all the indicators.Results Serum KL-6 level of patients in lung injury group was higher than that of non-lung injury group at each time point(P<0.001).Serum KL-6 levels of the 2 groups at T3 and T4 time points were higher than those at T1 and T2 time points(P<0.05).For lung injury group and non-lung injury group,the case number of dissection stage(acute stage)and the case number of involving superior mesenteric artery,white blood cell(WBC),high-sensitivity C-reactive protein(hs-CRP)and serum KL-6 levels had statistical significance between lung injury and non-lung injury groups(P<0.05).Multivariate Logistic regression analysis showed that hs-CRP[odds ratio(OR)=2.063,95%confidence interval(CI)1.104-3.854]and serum KL-6(OR=2.555,95%CI 1.272-5.133)are independent risk factors for acute lung injury in Standford aortic type A dissection(P<0.05).Pearson correlation analysis results showed that serum KL-6 and hs-CRP were negatively correlated with oxygenation index(r=-0.561 and-0.368,P<0.01).Conclusions Serum KL-6 levels are correlated with the occurrence of acute lung injury in Standford aortic type A dissection.