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Development and practical use of predictive methods of adult respiratory distress syndrome in patients with sepsis

脓毒症患者成人呼吸窘迫综合征预测方法的开发和实践应用

基本信息

批准号：
06557146
负责人：
TANIGUCHI Naoyuki
金额：
$ 5.31万
依托单位：
Osaka University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Developmental Scientific Research (B)
财政年份：
1994
资助国家：
日本
起止时间：
1994 至 1995
项目状态：
已结题

项目摘要

Adult respiratory distress syndrome (ARDS) can develop as a complication of various disorders, including sepsis, but it has not been possible to identify which of the patients at risk will develop serious disorfer. We have established a more rapid and easy method to measure serum levels of manganese superoxide dismutase than before and investigated the ability of six markers, measured sequentially in blood, to predict development of ARDS in patients with sepsis.At the initial diagnosis of sepsis (6-24h before the development of ARDS), serum manganese superoxide dismutase concentration and catalase activity were higher in the 6 patients who subsequently developed ARDS than in patients who did not develop ARDS.These changes in antioxidant enzymes predicted the development of ARDS in septic patients with the same sensitivity, specificity, and efficiency as simultaneous assessments of serum lactate dehydrogenase activity and factor VIII concentration. By contrast, serum glutathione peroxidase activity and alpha Pi-elastase complex concentration did not differ at the initial diagnosis of sepsis between patients who did and did not subsequently develop ARDS,and were not as effective in predicting the development of ARDS.Measurement of manganese superoxide dismutase, in addition to the other markers, should facilitate identification of patients at highest risk of ARDS and allow prospective treatment.

成人呼吸窘迫综合征（ARDS）可作为多种疾病（包括败血症）的并发症发生，但尚不可能确定哪些高危患者会发生严重疾病。我们已经建立了一种比以前更快速和简单的方法来测量血清锰超氧化物歧化酶水平，并研究了在血液中连续测量的六种标志物预测脓毒症患者ARDS发展的能力。（发生ARDS前6- 24 h），6例继发ARDS患者血清锰超氧化物歧化酶浓度和过氧化氢酶活性均高于未发生ARDS的患者，酶预测脓毒症患者ARDS的发展与同时评估血清乳酸脱氢酶活性和因子VIII浓度具有相同的敏感性、特异性和有效性。相比之下，血清谷胱甘肽过氧化物酶活性和α Pi-弹性蛋白酶复合物的浓度并没有显着差异，在最初诊断的脓毒症的患者之间，谁没有随后发展的ARDS，并没有有效的预测ADRS.Measurement锰超氧化物歧化酶的发展，除了其他标志物，应有助于识别患者的最高风险的ARDS，并允许前瞻性治疗。