中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2014年
3期
248-251
,共4页
杨松斌%吕庆伟%周晶%黄杭斌%章国海
楊鬆斌%呂慶偉%週晶%黃杭斌%章國海
양송빈%려경위%주정%황항빈%장국해
Clara细胞蛋白%重型颅脑创伤%急性肺损伤%急性呼吸窘迫综合征
Clara細胞蛋白%重型顱腦創傷%急性肺損傷%急性呼吸窘迫綜閤徵
Clara세포단백%중형로뇌창상%급성폐손상%급성호흡군박종합정
Clara cell protein%Severe traumatic injury%Acute lung injury%Acute respiratory distress syndrome
目的 揭示重型颅脑创伤患者血浆Clara细胞蛋白浓度,探讨其对并发急性肺损伤和急性呼吸窘迫综合征的预测价值.方法 收集112例重型颅脑创伤患者,用ELISA法检测血浆Clara细胞蛋白浓度,统计分析其与并发急性肺损伤和急性呼吸窘迫综合征的相关性.结果 重型颅脑创伤并发急性肺损伤36例(32.1％),并发急性呼吸窘迫综合征14例(12.5％).Logistic回归分析显示,血浆Clara细胞蛋白浓度是并发急性肺损伤(Or=1.352,95％ CI=1.121 ～3.457,P＜0.01)和急性呼吸窘迫综合征(Or =1.442,95％ CI =1.139～3.782,P＜0.01)的独立危险因素.ROC曲线分析显示,血浆Clara细胞蛋白浓度预测并发急性肺损伤(曲线下面积=0.847,95％ CI =0.782～0.909,P＜0.01)和急性呼吸窘迫综合征(曲线下面积=0.856,95％ CI=0.791 ～0.917,P＜0.01)有显著预测价值,判定血浆Clara细胞蛋白浓度大于26.6 ng/ml,对预测并发急性肺损伤有83.3％的灵敏度和76.3％的特异度,判定血浆Clara细胞蛋白浓度大于27.4 ng/ml,对预测重型颅脑创伤并发急性呼吸窘迫综合征有78.6％的灵敏度和83.7％的特异度.结论 血浆Clara细胞蛋白浓度能较好地预测重型颅脑创伤并发急性肺损伤和急性呼吸窘迫综合征.
目的 揭示重型顱腦創傷患者血漿Clara細胞蛋白濃度,探討其對併髮急性肺損傷和急性呼吸窘迫綜閤徵的預測價值.方法 收集112例重型顱腦創傷患者,用ELISA法檢測血漿Clara細胞蛋白濃度,統計分析其與併髮急性肺損傷和急性呼吸窘迫綜閤徵的相關性.結果 重型顱腦創傷併髮急性肺損傷36例(32.1％),併髮急性呼吸窘迫綜閤徵14例(12.5％).Logistic迴歸分析顯示,血漿Clara細胞蛋白濃度是併髮急性肺損傷(Or=1.352,95％ CI=1.121 ～3.457,P＜0.01)和急性呼吸窘迫綜閤徵(Or =1.442,95％ CI =1.139～3.782,P＜0.01)的獨立危險因素.ROC麯線分析顯示,血漿Clara細胞蛋白濃度預測併髮急性肺損傷(麯線下麵積=0.847,95％ CI =0.782～0.909,P＜0.01)和急性呼吸窘迫綜閤徵(麯線下麵積=0.856,95％ CI=0.791 ～0.917,P＜0.01)有顯著預測價值,判定血漿Clara細胞蛋白濃度大于26.6 ng/ml,對預測併髮急性肺損傷有83.3％的靈敏度和76.3％的特異度,判定血漿Clara細胞蛋白濃度大于27.4 ng/ml,對預測重型顱腦創傷併髮急性呼吸窘迫綜閤徵有78.6％的靈敏度和83.7％的特異度.結論 血漿Clara細胞蛋白濃度能較好地預測重型顱腦創傷併髮急性肺損傷和急性呼吸窘迫綜閤徵.
목적 게시중형로뇌창상환자혈장Clara세포단백농도,탐토기대병발급성폐손상화급성호흡군박종합정적예측개치.방법 수집112례중형로뇌창상환자,용ELISA법검측혈장Clara세포단백농도,통계분석기여병발급성폐손상화급성호흡군박종합정적상관성.결과 중형로뇌창상병발급성폐손상36례(32.1％),병발급성호흡군박종합정14례(12.5％).Logistic회귀분석현시,혈장Clara세포단백농도시병발급성폐손상(Or=1.352,95％ CI=1.121 ～3.457,P＜0.01)화급성호흡군박종합정(Or =1.442,95％ CI =1.139～3.782,P＜0.01)적독립위험인소.ROC곡선분석현시,혈장Clara세포단백농도예측병발급성폐손상(곡선하면적=0.847,95％ CI =0.782～0.909,P＜0.01)화급성호흡군박종합정(곡선하면적=0.856,95％ CI=0.791 ～0.917,P＜0.01)유현저예측개치,판정혈장Clara세포단백농도대우26.6 ng/ml,대예측병발급성폐손상유83.3％적령민도화76.3％적특이도,판정혈장Clara세포단백농도대우27.4 ng/ml,대예측중형로뇌창상병발급성호흡군박종합정유78.6％적령민도화83.7％적특이도.결론 혈장Clara세포단백농도능교호지예측중형로뇌창상병발급성폐손상화급성호흡군박종합정.
Objective To determine the plasma Clara cell protein concentration in patients with severe traumatic craniocerebral injury and to evaluate its prognostic value for acute lung injury and acute respiratory distress syndrome (ARDS).Methods 112 patients with severe traumatic craniocerebral injury were recruited.The concentration of plasma Clara cell protein was measured with ELISA.Its correlation with acute lung injury and ARDS was analyzed statistically.Results 36 patients (32.1％) suffered from acute lung injury and 14 patients (12.5％) had ARDS.A multivariate logistic regression showed that the plasma Clara cell protein concentration was an independent predictor for acute lung injury (Or =1.352,95％ CI =1.121 ～3.457,P ＜0.01) and ARDS (Or =1.442,95％ CI =1.139 ～3.782,P ＜0.01).A receiver operating characteristic curve showed that the plasma Clara cell protein level ＞ 26.6 ng/ml predicted acute lung injury with 83.3％ sensitivity and 76.3％ specificity (area under curve =0.847,95％ CI =0.782 ～ 0.909,P ＜ 0.01) and that plasma Clara cell protein level ＞ 27.4 ng/ml predicted ARDS with 78.6％ sensitivity and 83.7％ specificity (area under curve =0.856,95％ CI =0.791 ～ 0.917,P ＜ 0.01).Conclusions The plasma Clara cell protein concentration could predict acute lung injury and ARDS secondary to severe traumatic craniocerebral injury.
