Study on relationship between extravascular lung water,TNF-α,E-selectin,vasostatin-2 and the prognosis of patients with ARDS
10.3760/cma.j.issn.1008-6706.2014.19.001
- VernacularTitle:血管外肺水、肿瘤坏死因子-α、E-选择素、血管抑制因子-2与急性呼吸窘迫综合征患者预后的相关性研究
- Author:
Chunyan YANG
;
Rumin ZHANG
;
Yun ZHANG
;
Shifu WANG
- Publication Type:Journal Article
- Keywords:
Extravascular lung water;
Tumor necrosis factor alpha;
E-selectin;
Angiostatins;
Respiratory dis-tress syndrome,adult
- From:
Chinese Journal of Primary Medicine and Pharmacy
2014;(19):2881-2883,2884
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the correlations between acute respiratory distress syndrome ( ARDS) and extravascular lung water(EVLW),tumor necrosis factor alpha (TNF-α),E-selectin,vasostatin-2.To discuss the value of EVLW, TNF-α, E-selectin and vasostatin-2 in evaluating the severity of ARDS and prognosis of this disease . Methods There are thirty-six patients with ARDS were selected .According to the level of EVLWI shown by pulse indicator continuous cardiac output ( PiCCO) monitor,they were divided into the two groups:EVLWI≥14mL/kg group (n=18) and EVLWI<14mL/kg group(n=18).To monitor and record the levels of EVLWI ,PVPI,CI,ITBV,record oxygenation index ,calculate APACHEII score .The levels of TNF-α,E-selectin and vasostatin-2 in serum were meas-ured by ELISA.Results In EVLWI≥14mL/kg group,the APACHEⅡscore was (23.93 ±4.44),28-day mortality was 61.1%,the stay time in ICU was (19.05 ±4.0) d,which were higher than those in EVLWI <14mL/kg group [APACHEII score (18.58 ±3.66),28-day mortality(27.8%),the stay time in ICU(14.35 ±3.39) d](t=3.941,χ2 =4.050,t=3.797,all P<0.01).And the levels of TNF-α[(85.28 ±18.25)μg/L]and E-selectin[(74.07 ± 14.57)μg/L]in serum were higher than in EVLWI <14mL/kg group[TNF-α(63.27 ±20.28)μg/L,E-selectin (40.99 ±16.35)μg/L](t=3.422,5.847,all P<0.01).The oxygenation index of EVLWI≥14mL/kg group was (122.86 ±25.45),which was lower than that in EVLWI <14mL/kg group[(156.77 ±37.58)](t=-3.170,P<0.01).In the two groups of patients still alive within 28 days,after active treatment for 72 hours,the level of EVLWI was significantly lower than before in these 20 patients(Z=-0.392,P<0.01),oxygenation index was significantly higher than before(Z=-3.845,P<0.01),and the levels of TNF-αand E-selectin were significantly lower than before(t=7.194,4.025,all P<0.01).But 16 patients in the death group,after active treatment for 72 hours,the levels of EVLWI ,TNF-α,E-selectin and oxygenation index had no significant change ,there was no statistically signifi-cant difference(P>0.05).EVLWI had positive correlation with PVPI,TNF-αand E-selectin (r=0.605,0.649, 0.549,all P<0.01),and EVLWI had a negative correlation with oxygenation index (r=-0.715,P<0.01).Results showed no difference in vasostatin-2 between the two groups(P>0.05).Conclusion There were significant correla-tions between EVLWI and TNF-α,E-selectin in patients with ARDS.The levels of EVLWI,TNF-α,E-selectin were higher,and the mortality rate was higher,the the stay time in ICU was longer.The levels of EVLWI,TNF-αand E-selectin can provide a good reference value to the judgement of the severity of disease and prognosis in patients with ARDS.The level of vasostatin-2 had no correlation with EVLWI .
