血浆GGPPS水平预测急性呼吸窘迫综合征严重程度及预后的研究

Study on the Prediction of Severity and Prognosis of Patients with ARDS by Plasma GGPPS Level

目的研究血浆香叶基香叶基焦磷酸合成酶(Geranyl geranyl diphosphate synthase,GGPPS)表达水平与急性呼吸窘迫综合征(Acute respiratory distress syndrome,ARDS)患者严重程度的关系及其预后的判断价值。方法通过酶联免疫吸附法(Enzyme linked immunosorbent assay,ELISA)检测ARDS患者(ARDS组)和健康人群(对照组)血浆GGPPS水平,比较两组血浆GGPPS表达情况,比较轻度、中度、重度ARDS患者GGPPS表达水平,并对ARDS患者死亡组与存活组血浆GGPPS表达水平进行比较,同时分析ARDS患者血浆GGPPS表达与其他临床指标的关系,并绘制受试者工作特征曲线(Receiver operating characteristic curve,ROC),判断血浆GGPPS表达水平对ARDS患者预后价值。结果ARDS组血浆GGPPS水平表达明显高于对照组,并随着病情加重表达水平增高。ARDS死亡组血浆GGPPS水平高于ARDS存活组。ARDS患者中血浆GGPPS水平高表达,与高APACHEⅡ评分(r=0.429,P=0.000)、高SOFA评分(r=0.305,P=0.006)、低氧合指数(r=-0.836,P=0.000)、高白细胞计数(r=0.340,P=0.002)、高C反应蛋白(r=0.325,P=0.003)及高Lac(r=0.438,P=0.000)相关。血浆GGPPS水平预测ARDS患者预后的AUC是0.764,对ARDS患者预后有预测价值,最佳预测阈值为134.92 ng/L。结论ARDS患者血浆GGPPS表达水平高于正常人群,且其表达水平与ARDS病情严重程度及预后相关,GGPPS有望成为评估ARDS病情严重程度及预后的生物标志物。

Objective To investigate the relationship between plasma GGPPS expression level and the severity of ARDS patients and its value in determining the prognosis of this disease.Method The plasma GGPPS level of ARDS patients(ARDS group)and healthy people(control group)were measured by enzyme linked immunosorbent assay(ELISA),and the plasma GGPPS expression of ARDS patients and control group were compared,and the GGPPS expression of mild,moderate and severe ARDS patients were compared.levels,and compared plasma GGPPS expression in the death group of ARDS patients with the surviving group,and analyzed the relationship between plasma GGPPS expression and other clinical indicators in ARDS patients,and plotted the receiver operating characteristic curve(ROC)to determine the predictive value of plasma GGPPS expression level on the prognosis of ARDS patients.Results Expression of plasma GGPPS level was significantly higher in the ARDS group than in the control group and increased with severity of disease(P<0.05).The GGPPS levels were higher in non-survivors than survivors in ARDS patients(P<0.05).High expression of plasma GGPPS level in ARDS patients was associated with high APACHEⅡscores(r=0.429,P=0.000),high SOFA score(r=0.305,P=0.006),low oxygenation index(r=-0.836,P=0.000),high white blood cell count(r=0.340,P=0.002),high C-reactive protein(r=0.325,P=0.003),and high Lac(r=0.438,P=0.000)Correlation.The AUC for plasma GGPPS levels to predict prognosis in ARDS patients was 0.764,which had predictive value in ARDS patients(P<0.05),with an optimal prediction threshold of 134.92 ng/L.Conclusion The expression level of plasma GGPPS in ARDS patients is higher than that in the normal population,and its expression level correlates with the severity and prognosis of ARDS,and GGPPS is expected to be a biomarker for assessing the severity and prognosis of ARDS.