Differences in inflammatory indicators and prognostic factors between pulmonary and extrapulmonary ARDS caused by sepsis
10.3969/j.issn.1671-8348.2025.06.004
- VernacularTitle:脓毒症导致的肺内源性与肺外源性ARDS患者炎症指标差异及预后影响因素分析
- Author:
Honglei QI
1
;
Xiaojuan YANG
;
Xiaojun YANG
;
Xigang MA
;
Xiaohong WANG
;
Huan DING
;
Jinyuan ZHU
Author Information
1. 宁夏医科大学第一临床医学院,银川 750004
- Keywords:
sepsis;
respiratory distress syndrome;
inflammatory markers;
lung;
prognosis
- From:
Chongqing Medicine
2025;54(6):1300-1306
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the influencing factors of pulmonary and extrapulmonary acute re-spiratory distress syndrome(ARDS)caused by sepsis.Methods A total of 126 patients with ARDS admitted to the Department of Critical Care Medicine,General Hospital of Ningxia Medical University,from January 2022 to June 2024 were selected.Patients were divided into pulmonary ARDS and extrapulmonary ARDS groups based on the etiology of ARDS.General data,inflammatory indicators,and prognostic outcomes were compared between the two groups.COX regression analysis was used to identify prognostic factors.Results A-mong the 126 patients,72 were diagnosed with pulmonary ARDS and 54 with extrapulmonary ARDS.The pulmonary ARDS group had significantly lower SOFA scores,fewer organ dysfunctions,a lower incidence of arrhythmia,shorter mechanical ventilation duration,higher Murray scores,and higher Charlson Comorbidity Index(CCI)compared to the extrapulmonary ARDS group(P<0.05).Inflammatory markers,including pro-calcitonin(PCT),C-reactive protein(CRP),interleukin(IL)-4,IL-6,IL-10,and tumor necrosis factor-α(TNF-α),were significantly lower in the pulmonary ARDS group,while interferon-γ(INF-γ)levels were higher(P<0.05).For pulmonary ARDS,CCI and TNF-α were identified as independent risk factors for prog-nosis(P<0.05),with the combination of CCI and TNF-α yielding the highest predictive accuracy(AUC=0.81,95%CI:0.71-0.91).For extrapulmonary ARDS,CCI and CRP were independent risk factors(P<0.05),and their combination achieved the highest predictive performance(AUC=0.91,95%CI:0.84-0.98).Conclusion Inflammatory profiles between pulmonary and extrapulmonary ARDS caused by sepsis are different.CCI and TNF-α are independent risk factors for mortality in pulmonary ARDS,while CCI and CRP are independent risk factors in extrapulmonary ARDS.
