| 陈鑫,许惠芬,王林华,等.血管生成素及其受体与降钙素原联合检测在急性肺损伤诊治中的作用[J].安徽医药,2019,23(2):320-323. |
| 血管生成素及其受体与降钙素原联合检测在急性肺损伤诊治中的作用 |
| Role of joint detection of angiogenin and its receptor combined with procalcitoin in the diagnosis and treatment of acute lung injury |
| 投稿时间：2017-08-30 |
| DOI： |
| 中文关键词: 急性肺损伤 血管生成素 降钙素原 预后 |
| 英文关键词: Acute lung injury Angiopoietin Procalcitonin Prognosis |
| 基金项目: |
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| 摘要点击次数: 1523 |
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| 中文摘要: |
| 目的 研究急性肺损伤(ALI)病人血清中血管生成素-1(Ang-1)、血管生成素-2(Ang-2)及其受体(Tie-2)与降钙素原(PCT)的变化规律,探讨Ang-1、Ang-2、Tie-2与PCT在ALI病情评估和预后判断中的临床意义。方法 选取2016年9月至2017年3月南通大学附属医院重症监护病房的病人102例为ALI组,同时选择50例体检健康者为对照组。ALI组根据病人开始入院到随访28 d结束后生存情况再分成存活组和死亡组,比较病人血清中Ang-1、Ang-2、Tie-2与PCT的前后变化及急诊脓毒症病死率评分(MEDS)的严重程度及对预后评估的临床价值。结果 ALI组血清Ang-1、Tie-2水平分别为(0.99±0.08)、(0.96±0.08)μg/L,对照组分别为(2.07±0.15)、(1.51±0.31)μg/L,ALI组显著高于对照组,均差异有统计学意义(t=78.921,P<0.001；t=228.818,P<0.001),ALI组Ang-2、PCT、MEDS评分分别为(18.63±3.03)μg/L、(9.52±1.22)μg/L、(10.59±2.06)分,对照组分别为(1.75±0.22)μg/L、(0.31±0.15)μg/L、(2.97±0.33)分,ALI组均显著低于对照组,差异有统计学意义(t=153.629,P<0.001；t=22.545,P<0.001；t=420.623,P<0.001)；存活组Ang-1、Tie-2分别为(0.85±0.32)、(1.08±0.64)μg/L,死亡组分别为(0.66±0.07)、(0.61±0.14)μg/L,存活组均显著高于死亡组,差异有统计学意义(t=20.241,P<0.001；t=16.515,P<0.001),存活组Ang-2、PCT分别为(0.85±0.32)、(8.20±0.93)μg/L、死亡组分别为(11.01±1.21)、(13.65±3.68)μg/L,存活组均显著低于死亡组,差异有统计学意义(t=14.197,P<0.001；t=277.114,P<0.001)；存活组病人入院24 h Ang-1、Tie-2分别为(0.85±0.32)、(1.08±0.64)μg/L,治疗28 d后分别为(1.30±0.57)、(1.49±0.57)μg/L,均显著升高,差异有统计学意义(t=35.805,P<0.001；t=10.441,P<0.001),入院24 h Ang-2、PCT分别为(8.30±0.98)、(8.20±0.93)μg/L,治疗28 d后分别为(2.09±1.56)、(4.88±1.64)μg/L,均显著降低,差异有统计学意义(t=797.817,P<0.001；t=8.323,P<0.001)。结论 通过抑制Ang-2、PCT的表达并促进Ang-1、Tie-2表达,可能有利于控制ALI病人的病情,发病时同时检测上述四项对ALI病人预后有较好的预测作用,可提高检出率。 |
| 英文摘要: |
| Objective To study the changes of serum angiogenin-1 (Ang-1),angiopoietin-2 (Ang-2),and its receptor (Tie-2) and procalcitonin (PCT) in patients with acute lung injury (ALI),and to investigate the clinical significance of Ang-1,Ang-2,Tie-2 and PCT in ALI disease assessment and prognosis.Methods A total of 102 patients admitted to the Intensive Care Unit (ICU) of the Affiliated Hospital of Nantong University from September 2016 to March 2017 were selected as the ALI group,and 50 healthy subjects were selected as the control group.According to the prognosis of patients after 28 days of treatment the patients were assigned into survival group and death group.Ang-1,Ang-2,Tie-2 and PCT changes and MEDS score before and after treatment were compared.ResultsThe levels of serum Ang-1 and Tie-2 in the ALI group were significantly higher than those of the control group [(0.99±0.08) μg/L vs. (2.07±0.15) μg/L,(0.96±0.08) μg/L vs. (1.51±0.31) μg /L,respectively],and the differences were statistically significant (t=78.921,P<0.001;t=228.818,P<0.001).The Ang-2,PCT,and MEDS scores of the ALI group were significantly lower than those of the control group [(18.63±3.03) μg/L vs. (1.75±0.22) μg/L,(9.52±1.22) μg/L vs. (0.31±0.15) μg/L,(10.59±2.06) μg/L vs. (2.97±0.33) μg/L,respectively],and the differences were statistically significant (t=153.629,P<0.001;t=22.545,P<0.001;t=420.623,P<0.001);Ang-1,Tie-2 of survival group were significantly higher than the death group [(0.85±0.32) μg/L vs. (0.66±0.07) μg/L,(1.08±0.64) μg/L vs.(0.61±0.14) μg/L,respectively]],and the differences were statistically significant (t=20.241,P<0.001;t=16.515,P<0.001).Ang-2 and PCT of survival group were significantly lower than those of the death group [(0.85±0.32) μg/L vs.(11.01±1.21) μg/L,(8.20±0.93) μg/ L vs. (13.65±3.68) μg/L,respectively],and the differences were statistically significant (t=14.197,P<0.001;t=277.114,P<0.001);,Ang-1,Tie-2 in the survival group after hospitalization for 24 h were significantly increased compared with after treatment for 28 days [(0.85± 0.32) μg/L vs. (1.30 ± 0.57) μg/L,(1.08 ± 0.64) μg/L vs. (1.49 ± 0.57) μg/L,respectively],and the differences were statistically significant (t=35.805,P<0.001;t=10.441,P<0.001);Ang-2 and PCT in the survival group after hospitalization for 24 h were significantly decreased compared with after treatment for 28 days [(8.30±0.98) μg/L vs. (2.09±1.56) μg/L,(8.20±0.93) μg/L vs.(4.88±1.64) μg/L,respectively],and the differences were statistically significant (t=797.817,P<0.001;t=8.323,P<0.001).Conclusions By inhibiting the expressions of Ang-2 and PCT and promoting the expressions of Ang-1 and Tie-2,it may be beneficial to control the condition of ALI patients;Ang-1,Ang-2,Tie-2 and PCT have a better predictive effect on the prognosis of ALI patients,and the detection rate can be improved by comprehensive detection. |
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