| 刘芳,刘立志,罗必成.脂肪细胞因子、还原型烟酰胺腺嘌呤二核苷酸磷酸氧化酶 4水平对急性呼吸窘迫综合征病情发展及预后判断的价值[J].安徽医药,2026,30(11):2244-2249. |
| 脂肪细胞因子、还原型烟酰胺腺嘌呤二核苷酸磷酸氧化酶 4水平对急性呼吸窘迫综合征病情发展及预后判断的价值 |
| Value of serum Apelin-13 and NOX4 levels in the assessment of disease progression and prognosis in patients with acute respiratory distress syndrome |
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| DOI：10.3969/j.issn.1009-6469.2026.11.023 |
| 中文关键词: 呼吸窘迫综合征，成人 血清脂肪细胞因子 还原型烟酰胺腺嘌呤二核苷酸磷酸氧化酶 4 预后 |
| 英文关键词: Respiratory distress syndrome, adult Serum Apelin-13 Reduced nicotinamide adenine dinucleotide phosphate oxi-dase 4 Prognosis |
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| 中文摘要: |
| 目的探究血清脂肪细胞因子( Apelin-13)还原型烟酰胺腺嘌呤二核苷酸磷酸氧化酶 4(NOX4)水平对急性呼吸窘迫综合征( ARDS)病情发展及预后判断的价值。方法，前瞻性研究 2023年 1月至 2023年 12月在监利市人民医院诊治的 ARDS病人 180例，根据 ARDS病人氧合指数( PaO2/FiO2)分为轻中度组( 124例)及重度组( 56例)根据 ARDS病人预后情况分为预后良好组( 108例)和预后不良组( 72例)。全自动生化分析仪检测肌酐( Cre)、血尿素氮( BUN)、，总蛋白( TP)、白蛋白( Alb)水平；ELISA检测 C反应蛋白( CRP)、降钙素原( PCT)、肿瘤坏死因子 α(TNF-α)、白细胞介素 -10(IL-10)、 Apelin-13、NOX4水平，同时记录急性生理学和慢性健康状况评价 Ⅱ(APACHE Ⅱ)评分及序贯器官衰竭( SOFA)评分。多因素 logistic回归分析预后不良的影响因素； Pearson相关性分析 Apelin-13，NOX4水平的相关性； ROC曲线分析 Apelin-13，NOX4对 ARDS病情进展及病人预后不良的诊断价值，通过 Z检验比较曲线下面积( AUC)的差异。结果重度组和预后不良组机械通气时间 ≥4 d所占比例、 APACHE Ⅱ评分［( 21.82±7.04)、(19.38±6.21)分比( 14.35±4.25)、(14.86±4.25)分］及 TNF-α［( 53.24±16.87)、(51.35±16.83)ng/L比( 46.28±14.63)、(46.52±14.23)ng/L］、 Apelin-13［( 83.24±26.17)、(76.47±24.73)μg/L比( 58.37±18.42)、(59.21±18.32)μg/L］、 NOX4［( 3.27±1.03)、(3.20±0.98)μg/L比( 2.23±0.73)、(2.12±0.68)μg/L］水平分别高于轻中度组和预后良好组( P<0.05)； APACHE Ⅱ评分及 Apelin-13、NOX4水平为 ARDS病人预后不良的独立危险因素( P<0.05)；重度组及预后不良病人 Apelin-13， NOX4水平正相关( P<0.05)； Apelin-13、NOX4联合( AUC=0.91)诊断 ARDS严重程度优于各自单独诊断( AUCApelin-13=0.80、 AUCNOX4=0.82)联合( AUC=0.93)诊断 ARDS病人预后不良也优于各自单独诊断( AUCApelin-13=0.83、AUCNOX4=0.87)(P<0.05)。结论 Apelin-13、N，OX4随着 ARDS严重程度增加而升高，两者联合诊断病情发展及预后具有一定的价值。 |
| 英文摘要: |
| Objective To investigate the value of serum Apelin-13 and reduced nicotinamide adenine dinucleotide phosphate oxi-dase 4 (NOX4) levels in the development and prognosis of acute respiratory distress syndrome (ARDS) patients.Methods This studyselected 180 ARDS patients who were treated in Jianli People's Hospital from January 2023 to December 2023. According to the oxy-genation index (PaO2/FiO2) of ARDS patients, they were separated into mild to moderate group (124 cases) and severe group (56 cases).According to the prognosis of ARDS patients, they were separated into a good prognosis group (108 cases) and a poor prognosis group(72 cases). Fully automated biochemical analyzer was applied to detect levels of creatinine (Cre), urea nitrogen (BUN), total protein(TP), and albumin (Alb). ELISA was applied to detect levels of C-reactive protein (CRP), procalcitonin (PCT), tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), Apelin-13, and NOX4, while Acute Physiological And Chronic Health Evaluation (APACHE Ⅱ)scores and Sequential Organ Failure Assessment (SOFA) scores were recorded. Multivariate logistic regression analysis method was ap-plied to analyze the influencing factors of poor prognosis. Pearson correlation was applied to analyze the correlation between Apelin-13 and NOX4 levels. ROC curve was applied to analyze the diagnostic value of Apelin-13 and NOX4 for the progression of ARDS and poor prognosis, and Z-test was used to compare the differences in area under the curve (AUC).Results The proportion of mechanical venti-lation time ≥ 4 days, APACHE Ⅱ score[(21.82±7.04), (19.38±6.21)points vs. (14.35±4.25), (14.86±4.25)points], and levels of TNF-α [(53.24±16.87), (51.35±16.83)ng/L vs. (46.28±14.63), (46.52±14.23)ng/L], Apelin-13[(83.24±26.17), (76.47±24.73)μg/L vs. (58.37± 18.42), (59.21±18.32)μg/L], and NOX4[(3.27±1.03), (3.20±0.98)μg/L vs. (2.23±0.73), (2.12±0.68)μg/L] in the severe group and poorprognosis group were higher than those in the mild to moderate group and good prognosis group, respectively (P<0.05). APACHE Ⅱ score and levels of Apelin-13 and NOX4 were independent risk factors for poor prognosis in ARDS patients (P<0.05). The levels of Apelin-13 and NOX4 were positively correlated (P<0.05) in the severe group and patients with poor prognosis. The combination of Ape-lin-13 and NOX4 (AUC=0.91) in diagnosing the severity of ARDS was better than their individual diagnoses (AUCApelin-13=0.80, AUCNOX4 =0.82), and the combination (AUC=0.93) in diagnosing poor prognosis in ARDS patients was also better than their individual diagnoses(AUCApelin-13=0.83, AUCNOX4=0.87) (P<0.05).Conclusion Apelin-13 and NOX4 increase with the severity of ARDS, and the combina-tion of the two has certain value in diagnosing the development and prognosis of the disease. |
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