Change of Angiopoietin-1 in the Peripheral Blood of Patients with Acute Respiratory Distress Syndrome and Its Relationship with Prognosis
10.3870/j.issn.1672-0741.2015.06.018
- VernacularTitle:血管生成素-1在急性呼吸窘迫综合征患者外周血中的变化及与预后的关系
- Author:
Hao DING
;
Li ZHU
;
Jian WANG
- Publication Type:Journal Article
- Keywords:
acute respiratory distress syndrome;
angiopoietin-1;
tyrosine kinase receptor;
prognosis
- From:
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
2015;(6):705-709
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the change of angiopoietin‐1(Ang‐1)in the peripheral blood of patients with acute re‐spiratory distress syndrome and its relationship with prognosis.Methods A total of 85 hospitalized patients with ARDS were recruited and divided into mild group(n=25) ,moderate group(n=36)and severe group(n=24)according to the oxidation states of patients.Another 40 hospitalized patients without ARDS were included as the control group.The basic clinical data of all pa‐tients were obtained.The expressions of Ang‐1 and Tie2 in the peripheral blood were detected by RT‐PCR.The correlation be‐tween the different variables was analyzed by using Pearson correlation analysis.All patients were divided into survival group(n=47)and death group(n=38)according to the deaths of patients after 28 days.The relevant factors for prognostic of patients with ARDS were analyzed by using multivariate Logistic regression analysis.The effectiveness of Ang‐1 in predicting ARDS was analyzed by using ROC curves.Results In ARDS patients relative to the control patients ,PaO2/FiO2 was decreased ,A‐PACHEⅡ score ,LIS score ,SOFA score ,C‐reactive protein(CRP) ,IL‐6 ,and mortality rates were increased ,and the relative ex‐pressions of Ang‐1 mRNA and Tie2 mRNA in the peripheral blood were decreased ,with the differences being statistically sig‐nificant(P<0.05).The relative expressions of Ang‐1 mRNA and Tie2 mRNA in the peripheral blood in severe group were much lower than in the mild group and moderate group ,those in the moderate group were lower than in the mild group ,and there were significant differences(P<0.05).Pearson correlation analysis showed that the expressions of Ang‐1 and Tie2 in the peripheral blood of patients with ARDS were positively correlated with PaO2/FiO2 (P<0.05) ,but were negatively correlated with APACHE Ⅱ score ,LIS score ,SOFA score ,CRP and IL‐6 levels(P< 0.05).Multivariate Logistic regression analysis showed that PaO2/FiO2 and APACHEⅡ score were independent risk factors for the mortality in patients with ARDS(P<0.05) ,while the relative expressions of Ang‐1 mRNA and Tie2 mRNA were protective factors for the mortality in patients with ARDS(P>0.05).ROC curve analysis showed that when the relative expression of Ang‐1 mRNA was used for the diagnosis of ARDS ,the area under the curve was 0.874(95% CI:0.809-0.938) ,the sensitivity was 72.5% ,and the specificity was 85.9% . Conclusion Down‐expression of Ang‐1 in the peripheral blood of patients with ARDS is closely related with the severity of the patient’s condition.It may accelerate the endothelial cell damage and increase the vascular permeability by reducing the binding to Tie2.It may be used as a prognostic indicator for patients with ARDS.
