生物标记物在肺挫伤中应用价值.docVIP

生物标记物在肺挫伤中应用价值 　　摘 要：急性炎症反应在肺挫伤的病理生理学中的重要作用已得到广泛认可，炎症反应是肺挫伤后病情演变加重的主要因素。肺挫伤与急性肺损伤和急性呼吸窘迫综合症的发生具有临床相关性已形成共识，然而免疫学评分和方法用于检测和评估肺挫伤的严重程度在临床中还没有建立，一种可能的方法是通过监测常规炎症标记物反映肺挫伤后发生的免疫反应。国外相关研究已表明炎症直接相关的生物标志物，如促血管生成素2、白介素6和降钙素原与炎症间接相关的标记物如人五聚素3和肾上腺髓质素原，它们都是ARDS的独立潜在危险因素。 　　关键词：生物标记物；肺挫伤；急性呼吸窘迫综合症 　　中图分类号：R563 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.08.011 　　文章编号：1006-1959（2018）08-0031-04 　　Application Value of Biomarkers in Lung Contusion 　　KAN Qiang-bo1，TIAN Can-qiong1，FU Yu-dong1，WANG Jun-feng1，HOU Bo1，HONG Zhi-peng2 　　（1.Department of Thoracic Surgery，the First Peoples Hospital of Qujing City，Qujing 655000，Yunnan，China； 　　2.Department of Thoracic Surgery，First Affiliated Hospital of Kunming Medical University，Kunming 650000，Yunnan，China） 　　Abstract：The important role of acute inflammatory reaction in the pathophysiology of lung contusion has been widely recognized. Inflammatory reaction is the main factor of exacerbation of the disease after lung contusion.There is a consensus that there is a clinical correlation between lung contusion and the occurrence of acute lung injury and acute respiratory distress syndrome.However， immunological scores and methods for detecting and evaluating the severity of lung contusion have not been established in clinical practice.One possible method is to monitor routine inflammatory markers to reflect the immune response after lung contusion.Foreign studies have shown that biomarkers directly related to inflammation，such as angiopoietin 2，interleukin 6 and calcitonin，are indirectly associated with inflammation，such as human pentagglutinin 3 and adrenomedullin，they are independent potential risk factors for ARDS. 　　Key words：Biomarkers；Pulmonary contusion；Acute respiratory distress syndrome 　　由美国和欧洲组成的关于急性呼吸窘迫综合症的研究团队定义，肺挫伤（pulmonary contusion，PC）是导致急性肺损伤（acute lung injury，ALI）和急性呼吸窘迫综合症（acute respiratory distress syndrome，ARDS）的最主要原因[1]。临床上肺挫伤影像所见的肺挫伤范围与临床症状不一致，提示肺挫伤的病理生理学中可能有?胞水平与亚细胞水平损伤、炎症以及肺挫伤与其它潜在损伤如误吸、感染等相互作用共同参与，相关研究表明炎症反应在