Serum ferritin as a predictor of the acute respiratory distress syndrome
Serum ferritin as a predictor of the acute respiratory distress syndrome
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DOI：
10.1164/ajrccm.155.1.9001283
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发表时间：
1997-01-01
影响因子：
24.7
通讯作者：
Repine, JE
中科院分区：
文献类型：
--
作者：
Connelly, KG;Moss, M;Repine, JE
我们研究了血清铁蛋白水平作为急性呼吸窘迫综合征（ARDS）的预测因子，因为：（1）与ARDS有关的促炎细胞因子会增加铁蛋白合成;（2）有ARDS风险的患者的氧化应激可能会从铁蛋白中释放铁，加速有毒的羟基自由基（。OH）形成。通过放射免疫测定法（RIA）测定的75例有ARDS风险的患者（女性，p < 0.0001;男性，p < 0.0001）和8例ARDS患者（女性，p = 0.001;男性，p = 0.0009）的血清铁蛋白水平高于健康对照组。发生ARDS的女性（p = 0.003）和男性（p = 0.003）高危患者的血清铁蛋白水平也高于未发生ARDS的患者。在女性中，超过270 ng/ml的值预测ARDS的敏感性为83%，特异性为71%，阳性预测值为67%，阴性预测值为86%。在男性中，超过680 ng/ml的值预测ARDS的敏感性为60%，特异性为90%，阳性预测值为75%，阴性预测值为82%。血清铁蛋白水平与C-反应蛋白水平无关，在内科或外科高危患者中无差异，且不受肝脏疾病的影响。评价高危患者血清铁蛋白水平有助于预测ARDS的发展，从而改善ARDS的研究和治疗。血清铁蛋白水平升高也可能调节铁参与氧化反应，导致ARDS。
We investigated serum ferritin levels as a predictor of the acute respiratory distress syndrome (ARDS) because: (1) proinflammatory cytokines, which are implicated in ARDS, increase ferritin synthesis; and (2) oxidative stress in patients at risk for ARDS might liberate iron from ferritin, accelerating toxic hydroxyl radical (. OH) formation. Serum ferritin levels measured by radioimmunoassay (RIA) were greater in 75 patients at risk for ARDS (women, p < 0.0001; men, p < 0.0001) and 8 patients with ARDS (women, p = 0.001; men, p = 0.0009) than in healthy control subjects. Serum ferritin levels were also greater in female (p = 0.003) and male (p = 0.003) at-risk patients who developed ARDS than in patients who did not develop ARDS. In women, a value exceeding 270 ng/ml predicted ARDS with an 83% sensitivity, 71% specificity, 67% positive, and 86% negative predictive value. In men, a value exceeding 680 ng/ml predicted ARDS with a 60% sensitivity, 90% specificity, 75% positive, and 82% negative predictive value. Serum ferritin levels did not correlate with C-reactive protein levels, were not different in medical or surgical at-risk patients, and were not accounted for by liver disease. Evaluating serum ferritin levels in at-risk patients may help predict the development of ARDS and thereby improve study and treatment of ARDS. Elevated serum ferritin levels may also regulate the participation of iron in the oxidative responses that contribute to ARDS.