血小板计数在肺部感染所致ALI/ARDS中的变化及与炎性因子、氧化应激等指标的相关性分析

Changes of platelet count in ALI/ARDS induced by lung infection and correlation analysis with inflammatory factors and oxidative stress indicators

目的:探讨肺部感染所致急性肺损伤/急性呼吸窘迫综合征(acute lung iniury,ALI)/(acute respiratory distress svndrome,ARDS)患者炎性因子、氧化应激指标水平,并分析其相关性。方法:选取2020年1月至2022年4月本院收治的116例肺部感染患者为研究对象,依据其是否合并ALI/ARDS分为对照组即单纯肺部感染52例、研究组即合并ALI/ARDS 64例。入组时采用ELISA法检测炎性因子水平。采用试剂盒检测氧化应激指标水平。分析炎性因子、氧化应激及肺部感染评分、急性生理与慢性健康状况Ⅱ、Murray肺损伤评分相关性。分析炎性因子、氧化应激指标对肺部感染所致ALI/ARDS的诊断价值。结果:与对照组比较,研究组血小板计数(Platelet count,PLT)降低,超氧化物歧化酶(Superoxide dismutase,SOD)、谷胱甘肽过氧化物酶(Glutathione peroxidase,GSH-px)水平降低,白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-18(Interleukin-8,IL-18)、肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)、过氧化脂质(Lipid peroxide,LPO)水平升高(P<0.05);PLT与IL-18、LPO及CPIS、APACHEⅡ、Murray评分呈负相关(P<0.05),而与SOD呈正相关(P<0.05);联合诊断肺部感染所致ALI/ARDS的AUC大于单项诊断(P<0.05)。结论:肺部感染所致ALI/ARDS患者中PLT降低,且与IL-18、LPO、SOD密切相关,联合检测PLT、IL-18、LPO、SOD对肺部感染所致ALI/ARDS具有一定诊断价值。

Objective:To investigate the levels of inflammatory factors and oxidative stress indicators in patients with acute lung injury/acute respiratory distress syndrome(ALI)/acute respiratory distress syndromes(ARDS)due to lung infection and to analyze their correlation.Methods:One hundred and sixteen patients with pulmonary infections admitted to our hospital from January 2020 to April 2022 were selected for the study,and were divided into a control group,i.e.,52 cases of simple pulmonary infections,and a study group,i.e.,64 cases of combined ALI/ARDS,according to whether they were combined with ALI/ARDS.The levels of inflammatory factors were measured by ELISA at the time of enrollment.The levels of oxidative stress indicators were measured by kits.The correlation between inflammatory factors,oxidative stress and lung infection scores,acute physiological and chronic health status II,and Murray lung injury scores was analyzed.To analyze the diagnostic value of inflammatory factors and oxidative stress indicators for ALI/ARDS due to lung infection.Results:Compared with the control group,the study group had lower platelet count(PLT),lower levels of superoxide dismutase(SOD)and glutathione peroxidase(GSH-px),lower levels of interleukin-6(IL-6),Interleukin-8(IL-18),Tumor Necrosis Factor-α(TNF-α),and Lipid peroxide(LPO)levels were increased(P<0.05);PLT and IL-18,LPO and CPIS,APACHE II and Murray scores were negatively correlated(P<0.05)and positively correlated with SOD(P<0.05);the AUC of combined diagnosis of ALI/ARDS due to pulmonary infection was greater than that of single diagnosis(P<0.05).Conclusion:PLT is reduced in patients with ALI/ARDS due to lung infection and is closely correlated with IL-18,LPO and SOD,and the combined detection of PLT,IL-18,LPO and SOD has some diagnostic value for ALI/ARDS due to lung infection.