血浆可溶性血管内皮生长因子受体1在重症肺炎患者中的诊断与预测价值.docVIP

精品论文 参考文献 血浆可溶性血管内皮生长因子受体1在重症肺炎患者中的诊断与预测价值 DOI：10.7504/nk2016010203 中图分类号：R587.1 文献标识码：A 　　摘要：目的 探讨血浆可溶性血管内皮生长因子受体1（sFLT-1）在重症肺炎患者中的检测水平变化及预测价值。方法 选取2013年10月-2016年4月入住我院RICU的重症肺炎患者60例（A组）、重症肺炎合并感染性休克组60例（B组）、重症肺炎合并MODS组60例（C组），选取入住呼吸科的普通肺炎患者60例作为对照组（D组）。比较各组患者入院第1d、3d、7d以及存活组和死亡组sFlt-1水平变化，分析血浆sFLT-1在重症肺炎中的预测价值及与APACHEⅡ评分的相关性。结果 A、B、C 3组的PCT和APACHE Ⅱ评分有显著差异（P均lt;0.01）。血浆sFLT-1水平在4组患者间有显著差异，A、B、C 3组第7d明显低于第1d（Plt;0.05）。重症肺炎死亡组sFLT-1水平显著高于存活组（637.6plusmn;222.0ng?L-1 vs 354.9plusmn;144.6ng?L-1，Plt;0.01）。重症肺炎sFLT-1水平和APACHE Ⅱ评分具有很强的相关性（r=0.647，Plt;0.001）。sFLT-1预测重症肺炎和28d死亡率的敏感度及特异度分别为77.8%、75.0%和69.7%、80.1%，AUC分别为 0.787（95%CI：72.6%~84.8%，Plt;0.001）和0.775（95%CI：70.5%~84.5%，Plt;0.001）。结论 早期检测血浆sFLT-1水平可以预测重症肺炎和28天病死率。 　　关键词：血浆sFLT-1；重症肺炎；预测价值 　　Diagnosis and predictive value of soluble vascular endothelial growth factor receptor-1 in severe pneumonia 　　GAO Yan-qiu1，ZHANG Hua 2，LI Shuang-feng1，SUN Guang-xin1，REN Ying-jie1（Affiliated Zhengzhou Central Hospital of Zhengzhou University，Zhengzhou 450007，China；1.Respiratory Intensive Care Unit 2.Department of Respiratory Medicine） 　　【Abstract】Objective To explore the diagnosis and predictive clinical value of soluble vascular endothelial growth factor receptor-1 （sFLT-1） in severe pneumonia. Method 60 patients（group A）with severe pneumonia，60 patients（group B）with severe pneumonia-related septic shock and 60 patients（group C）with severe pneumonia-related MODS in our RICU were admitted from October 2013 to April 2016 in the study. 60 cases of common community-acquired pneumonia in department of respiratory medicine were included for comparison（group D）. Plasma levels of sFLT-1 were measured at 1st，3st and 7st respectively. The association sFLT-1 with APACHE Ⅱscores and predictive value of sFLT-1 for severe pneumonia were analyzed. Results The differences were statistically significant for the levels of serum PCT and APACHE Ⅱ scores among three groups（Plt;0.01）.There were significant differences for plasma level