Serial Measurements of Protein Biomarkers in Sepsis-Induced Acute Respiratory Distress Syndrome.
Serial Measurements of Protein Biomarkers in Sepsis-Induced Acute Respiratory Distress Syndrome.
复制标题
DOI：
10.1097/cce.0000000000000780
复制
发表时间：
2022-10
影响因子：
--
通讯作者：
中科院分区：
文献类型：
--
作者：
蛋白质生物标志物的早期连续测量在脓毒症引起的急性呼吸窘迫综合征（ARDS）中的作用尚不清楚。确定患有和不患有 ARDS 的脓毒症患者之间可溶性晚期糖基化终产物受体 (sRAGE)、血管生成素-2 和表面活性蛋白-D (SP-D) 水平的差异及其随时间的变化。对脓毒症诊断后 72 小时内入住格雷迪纪念医院内科 ICU 的成年患者进行前瞻性观察队列研究。入组后连续 3 天测量血浆 sRAGE、血管生成素-2 和 SP-D 水平。主要结局是 ARDS 的发生，次要结局是 28 天死亡率。比较了 ARDS 和非 ARDS 患者以及非幸存者和幸存者之间的生物标志物水平及其随时间的变化。我们招募了 111 名患者，其中 21 名患者 (18.9%) 出现 ARDS。在所有 3 天的测量中，ARDS 和非 ARDS 患者之间的三种生物标志物水平没有显着差异。在多天内，非幸存者的所有三种生物标志物水平均高于幸存者。结果组之间生物标志物水平随时间的变化没有差异。 Logistic 回归分析显示第 1 天 SP-D 水平与死亡率之间存在关联（比值比，1.52；95% CI，1.03-2.24；p = 0.03），广义估计方程分析显示血管生成素-2 水平与死亡率之间存在关联（估计值 0.0002；se 0.0001；p = 0.04）。在脓毒症危重患者中，ARDS 和非 ARDS 患者的 sRAGE、血管生成素-2 和 SP-D 水平没有显着差异，但非幸存者中的 sRAGE、血管生成素-2 和 SP-D 水平高于幸存者。 ARDS 患者中 sRAGE 和 SP-D 水平升高的趋势，但血管生成素-2 水平没有升高，这可能表明上皮损伤在脓毒症诱发的 ARDS 中的重要性。结果组之间生物标志物水平随时间的变化没有差异。
The role of early, serial measurements of protein biomarkers in sepsis-induced acute respiratory distress syndrome (ARDS) is not clear. To determine the differences in soluble receptor for advanced glycation end-products (sRAGEs), angiopoietin-2, and surfactant protein-D (SP-D) levels and their changes over time between sepsis patients with and without ARDS. Prospective observational cohort study of adult patients admitted to the medical ICU at Grady Memorial Hospital within 72 hours of sepsis diagnosis. Plasma sRAGE, angiopoietin-2, and SP-D levels were measured for 3 consecutive days after enrollment. The primary outcome was ARDS development, and the secondary outcome of 28-day mortality. The biomarker levels and their changes over time were compared between ARDS and non-ARDS patients and between nonsurvivors and survivors. We enrolled 111 patients, and 21 patients (18.9%) developed ARDS. The three biomarker levels were not significantly different between ARDS and non-ARDS patients on all 3 days of measurement. Nonsurvivors had higher levels of all three biomarkers than did survivors on multiple days. The changes of the biomarker levels over time were not different between the outcome groups. Logistic regression analyses showed association between day 1 SP-D level and mortality (odds ratio, 1.52; 95% CI, 1.03–2.24; p = 0.03), and generalized estimating equation analyses showed association between angiopoietin-2 levels and mortality (estimate 0.0002; se 0.0001; p = 0.04). Among critically ill patients with sepsis, sRAGE, angiopoietin-2, and SP-D levels were not significantly different between ARDS and non-ARDS patients but were higher in nonsurvivors compared with survivors. The trend toward higher levels of sRAGE and SP-D, but not of angiopoietin-2, in ARDS patients may indicate the importance of epithelial injury in sepsis-induced ARDS. Changes of the biomarker levels over time were not different between the outcome groups.
影响因子：
38.9
作者：
van der Heijden, Melanie;Pickkers, Peter;Amerongen, Geerten P. van Nieuw;van Hinsbergh, Victor W. M.;Bouw, Martijn P. W. J. M.;van der Hoeven, Johannes G.;Groeneveld, A. B. Johan
通讯作者：
Groeneveld, A. B. Johan