Objective To investigate the clinical significance and levels of plasma renin activity (PRA), Angiotensin (Ang) Ⅱ in ALI / ARDS patients. Methods The levels of PRA and AngⅡ, APACHE Ⅱ score, lung injury score(LIS), and mortality were analyzed in ALI/ARDS patients and non-ALI/ARDS group. After the patients were grouped accord-ing to prognosis, correlation analysis and ROC curve to evaluate diagnostic efficacy of PRA and AngⅡ were performed. Results Compared with non- ALI/ARDS group, the levels of PRA and AngⅡ were significantly increased in ALI/ARDS (P<0.05). In the death group, the levels of PRA and AngⅡwere higher than that of the survival group (P<0.05). It was significant positive correlation between APACHEⅡ score,LIS,lactic acid (LAC) and PRA, so as AngⅡ. In pre-dicting ALI/ARDS, PRA was significant (AUC=0.705, P=0.001), so as AngⅡ(AUC=0.672, P =0.007). In predict-ing ALI/ARDS, there was no significant difference between PRA and LIS (P=0.923), and also between AngⅡ and LIS (P = 0.713). Conclusion In ALI/ARDS patients, the levels of PRA and AngⅡwere significantly increased, and both could be used to predict ALI/ARDS and determine its prognosis, but AngⅡhad higher specificity in predicting ALI/ARDS.

Objective To investigate the significance of plasma levels of insulin-like growth factor(IGF)-1 and insulin-like growth factor binding protein(IGFBP)-3 in predicting acute respiratory distress syndrome(ARDS)and prognosis in critical patients.Methods A totally of 131 critical patients in intensive care unit(ICU)of the First Affiliated Hospital of Wenzhou Medical University were reviewed.Plasma concentrations of IGF-1,IGFBP-3,blood biochemistry,procalcitonin(PCT),lactic acid(LAC)and blood albumin were measured in enrolled patients.The 60-day fatality of enrolled patients was calculated.The differences between ARDS group and control group,as well as 60-day dead group and survival group were compared.Results Plasma IGF-1 and IGFBP-3 in ARDS group were significantly lower than those in control group,while plasma PCT was higher than that in control group.Plasma levels of IGF-1 and IGFBP-3 in dead group were significantly lower than those in survival group.Multivariate Logistic regression analysis and receiver operating characteristic curve results showed that IGF-1 area under curve(AUC)was 0.770,sequential organ failure assessment(SOFA)(AUC=0.692)and PCT(AUC=0.710)were independent risk factors for ARDS in critical patients.IGF-1(AUC=0.807),IGFBP-3(AUC=0.759)and SOFA score(AUC=0.859)were independent risk factors for death in critical patients.Conclusion The plasma levels of IGF-1 and IGFBP-3 in critica patients are significantly decreased,which may be an important factor for ARDS risk and fatality in critical patients.