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基于两种因子同步检测方法探讨TNF-α及IL-6在预测ARDS发生中的作用
Role of plasma TNF-α and IL-6 levels in prediction of acute respiratory distress syndrome based on their synchronous detection
- 第三军医大学学报 2020年42卷第5期 页码：493-498
- 作者机构：
1.400037 重庆，陆军军医大学(第三军医大学)第二附属医院:呼吸与危重症医学中心
2.400037 重庆，陆军军医大学(第三军医大学)第二附属医院:老年与特勤医学科
- 作者简介：
[胡明冬，E-mail: huhanshandd@163.comHU Mingdong, E-mail: huhanshandd@163.com
- 基金信息：陆军军事医学创新工程专项(18CXZ002);陆军军医大学第二附属医院临床科研重点项目(2016YLC06)
DOI：10.16016/j.1000-5404.201909207
中图分类号： R446.11;R446.62;R563.8收稿：2019-09-27，
修回：2020-01-02，
纸质出版：2020-03-15
- 稿件说明：
移动端阅览
甘志新, 贺斌峰, 徐剑铖, 等. 基于两种因子同步检测方法探讨TNF-α及IL-6在预测ARDS发生中的作用[J]. 第三军医大学学报, 2020,42(5):493-498.
Zhixin GAN, Binfeng HE, Jiancheng XU, et al. Role of plasma TNF-α and IL-6 levels in prediction of acute respiratory distress syndrome based on their synchronous detection[J]. Journal of Third Military Medical University, 2020, 42(5): 493-498.
甘志新, 贺斌峰, 徐剑铖, 等. 基于两种因子同步检测方法探讨TNF-α及IL-6在预测ARDS发生中的作用[J]. 第三军医大学学报, 2020,42(5):493-498. DOI： 10.16016/j.1000-5404.201909207.
Zhixin GAN, Binfeng HE, Jiancheng XU, et al. Role of plasma TNF-α and IL-6 levels in prediction of acute respiratory distress syndrome based on their synchronous detection[J]. Journal of Third Military Medical University, 2020, 42(5): 493-498. DOI： 10.16016/j.1000-5404.201909207.
摘要
目的
2
探讨高危患者入院时血浆TNF-α及IL-6水平在预测急性呼吸窘迫综合征(acute respiratory distress syndrome，ARDS)发生中的作用。
方法
2
纳入2018年6月至2019年4月本院呼吸与危重症医学中心ICU的高危患者30例，其中13例发展成为ARDS(ARDS组)，其余17例为高危组。收集入组患者的临床资料及刚入院时的血浆标本。此外，收集18例正常人血浆标本作为对照(对照组)。应用流式细胞仪，用两种因子同步检测试剂盒对样本中的TNF-α、IL-6进行定量检测。
结果
2
ARDS组患者血浆TNF-α和IL-6水平明显高于高危组及对照组，高危组患者血浆TNF-α和IL-6水平明显高于对照组(
P
<
0.05)。血浆TNF-α水平与高危患者进展成为ARDS有密切关联；此外，ARDS组患者APACHE-Ⅱ评分、C反应蛋白、降钙素原、直接胆红素及乳酸水平明显高于高危组患者，而氧合指数、白蛋白水平明显低于高危组患者(
P
<
0.05)。入组患者中死亡人数与存活人数均为15人，两组间TNF-α与IL-6水平未见统计学差异(
P
>
0.05)。死亡组APACHE-Ⅱ评分、C反应蛋白、尿素、尿酸水平明显高于存活组，而血浆总蛋白、白蛋白及氧合指数明显低于存活组(
P
<
0.05)。
结论
2
入院时血浆中TNF-α水平与高危患者进展成为ARDS有密切关联，可作为预测ARDS发生的标志物。
Abstract
Objective
2
To investigate the role of plasma TNF-α and IL-6 levels in prediction of occurrence of acute respiratory distress syndrome (ARDS) in high-risk patients.
Methods
2
A total of 30 patients who were at high risk for ARDS and enrolled in ICU of our Center of Respiratory and Critical Care Medicine from June 2018 to April 2019 were subjected in this study. Among them
13 developed into ARDS (ARDS group)
and the other 17 served as high risk group. Their clinical data and plasma samples at admission were collected. Plasma samples from 18 heath volunteers were also harvested. The soluble proteins
TNF-α and IL-6
in the samples were quantitatively detected by flow cytometry.
Results
2
The plasma levels of TNF-α and IL-6 were significantly higher in the ARDS patients than the high risk group and health control
while those in the high risk group also higher than those in the health control group (
P
<
0.05). The TNF-α level was closely associated with the progression of ARDS in high-risk patients. Furthe
rmore
the patients of the ARDS group had significantly higher APACHE-Ⅱ score and higher levels of C-reactive protein
procalcitonin
direct bilirubin and lactic acid
while obviously lower oxygenation index and albumin level when compared with the high risk group (
P
<
0.05). Finally
from the 30 high risk patients
15 died and 15 survived
and there were no notable differences in the TNF-α and IL-6 levels between the dead and survival (
P
>
0.05). But the dead still had remarkably higher APACHE-Ⅱ score and levels of C-reactive protein
urea and uric acid
while obviously lower albumin
total plasma protein and oxygenation index than the survival (
P
<
0.05).
Conclusion
2
The plasma TNF-α level at admission is closely associated with the progression of ARDS in high-risk patients
and might be regarded as a marker to predict its occurrence.
关键词
Keywords
references
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