Immature granulocytes: A novel biomarker of acute respiratory distress syndrome in patients with acute pancreatitis
Immature granulocytes: A novel biomarker of acute respiratory distress syndrome in patients with acute pancreatitis
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未成熟粒细胞：急性胰腺炎患者急性呼吸窘迫综合征的新型生物标志物
DOI：
10.1016/j.jcrc.2018.12.002
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发表时间：
2019-04-01
影响因子：
3.7
通讯作者：
Tan, Chaochao
中科院分区：
文献类型：
--
作者：
Huang, Ying;Xiao, Jie;Tan, Chaochao
目的：为探讨急性胰腺炎（AP）患者未成熟粒细胞百分比（IG%）与急性呼吸窘迫综合征（ARDS）的关系，材料与方法：对2289例AP患者进行前瞻性多中心研究，其中1933例为AP患者。在入院时采集用于IG%分析的血样，并使用血液分析仪进行处理。前瞻性收集人口学、影像学和临床实验室资料，并进行回顾性分析。结果：IG%的增加反映了ARDS发病率和严重程度的明显上升趋势。多因素Logistic回归分析显示，急性生理和慢性健康状况评分（APACHE）II、CT严重指数、C反应蛋白、白色细胞、粒细胞、淋巴细胞和IG%（OR 1.297 [95%CI 1.230-1.368]）是预测AP患者发生ARDS的独立因素。受试者工作特征曲线分析显示，APACHE II和IG%的曲线下面积分别为0.837（95% CI 0.798-0.876）和0.821（95% CI 0.794-0.849）。APACHE Ⅱ评分与IG%联合应用对急性呼吸窘迫综合征（ARDS）的发生有较好的预测价值。结论：IG%是急性呼吸窘迫综合征（AP）患者ARDS的一种新的生物标志物。这可以促进在疾病的早期阶段及时和有效地识别处于ARDS高风险的个体。(C)2018爱思唯尔公司All rights reserved.
Purpose: To investigate the relationship between immature granulocyte percentage (IG%) and acute respiratory distress syndrome (ARDS) in patients with acute pancreatitis (AP).Materials and methods: A cohort of 2289 patients with AP was screened; 1933 were enrolled in this prospective multicenter study. Blood samples for IG% analysis were collected on admission and processed using a hematology analyzer. Demographic, radiological, and clinical laboratory data were prospectively collected and reviewed retrospectively.Results: Increased IG% reflected significant upward tendency of ARDS incidence and severity. Multivariable logistic regression revealed that Acute Physiology and Chronic Health Evaluation (APACHE) II, CT severity index, C-reactive protein, white blood cells, granulocytes, lymphocytes, and IG% (OR 1.297 [95% CI 1.230-1.368]) were independent factors predicting ARDS onset in patients with AP. Receiver operating characteristic curve analysis revealed that area under the curve for APACHE II and IG% were 0.837 (95% CI 0.798-0.876) and 0.821 (95% CI 0.794-0.849), respectively. The combination of APACHE II score and IG% demonstrated excellent predictive power for ARDS incidence.Conclusions: IG% is a new type of biomarker for ARDS in patients with AP. which may promote timely and efficient identification of individuals at high risk for ARDS in the early stages of disease. (C) 2018 Elsevier Inc. All rights reserved.