肝素结合蛋白在急性呼吸窘迫综合征中意义.docVIP

肝素结合蛋白在急性呼吸窘迫综合征中意义 　　【摘要】目的 探讨导致血管渗漏的细胞因子肝素结合蛋白（heparin-binding protein，HBP） 在脓毒症相关急性呼吸窘迫综合征（acute respiratory distress syndrome， ARDS）发病过程中起到的作用，并评价HBP水平对ARDS的预测价值。方法 本前瞻性调查研究共纳入符合脓毒症诊断标准患者67例，根据是否出现ARDS分为ARDS组及非ARDS组。收集患者明确脓毒症诊断2 h内动脉血，留取血清ELISA法检测白介素（interleukin， IL）-6、IL-8以及HBP水平，统计中性粒细胞水平，并进行急性生理与慢性健康评分系统Ⅱ评分。根据方差齐性进行t或t’检验比较两组之间IL-6、IL-8、中性粒细胞水平以及HBP的差异；使用Spearman相关检验对HBP与其他三项指标进行分析；建立受试者工作特征曲线并计算曲线下面积以分析HBP对脓毒症相关ARDS的预测价值。结果 ARDS组患者（32例）与非ARDS组（35例）患者比较，IL-6（t=4.25，P 　　【关键词】肝素结合蛋白；脓毒症；急性呼吸窘迫综合征；白介素-6；白介素-8；中性粒细胞；APACHEⅡ评分；血管渗漏 　　The role of heparin-binding protein in acute respiratory distress syndrome Liu Yang， Wang Xuebin， Ma Shaolin， Xu Wei. Department of Centre ICU， East Hospital， Tongji University School of Medicine， Shanghai 200120， China 　　Corresponding author：Wang Xuebin， Email： wxuebin@163.com 　　【Abstract】Objective To study the role of heparin-binding protein （HBP） in sepsis-associated acute respiratory distress syndrome （ARDS） ，and to evaluate the prognostic value of HBP in ARDS. Method Sixty seven sepsis patients were enrolled in the prospective study. According to whether present ARDS， patients were divided into two groups： ARDS group and non-ARDS group. Blood samples were obtained within 2 hours after patients were diagnosed with sepsis. We measured the level of interleukin-6， interleukin-8 and HBP by ELISA， counted the number of polymorphonuclear neutrophils（PMN）， and calculated Acute Physiology and Chronic Health Evaluation Ⅱ score. We compared interleukin-6， interleukin-8， PMN and HBP between two groups by Student’s t test. Correlation analysis was studied between HBP and other indicators by Spearman rank correlation coefficient. We also studied the early prognostic value on sepsis-associated ARDS by establishing receiver operating characteristic （ROC） curve. Results Interleukin-6（t=4.25，P 　　【Key words】Heparin-binding protein；Sepsis；ARDS； Interleukin-6；Interleukin-8；Neutrophils；APACHEⅡ score；Vascular leakage 　　急性肺损伤/急性呼吸窘迫综合征（acute resp