CAJ | 학술논문

目的：探讨可溶性晚期糖基化终末产物受体（sRAGE）在急性呼吸窘迫综合征（ARDS）患者诊断及预后预测中的价值。方法选取2012年3月-2013年3月入住辽宁医学院附属第一医院重症监护病房的 ARDS 患者60例为 ARDS 组，根据氧合指数（PaO2/ FiO2）将 ARDS 组分为轻度 ARDS 组（23例）、中度 ARDS 组（23例）及重度ARDS 组（14例），根据预后分为死亡组（18例）及存活组（42例）；另选择同时期入住重症监护病房的非 ARDS 患者60例为非 ARDS 组。采用酶联免疫吸附试验（ELISA）法检测患者血浆 sRAGE 水平，记录患者PaO2/ FiO2。结果ARDS 组较非 ARDS 组患者 sRAGE 水平升高，PaO2/ FiO2降低，差异有统计学意义（P é0.05）。不同严重程度 ARDS 组患者 sRAGE 水平及PaO2/ FiO2比较，差异均有统计学意义（P é0.05）；其中中度 ARDS 组、重度 ARDS 组较轻度 ARDS组，重度 ARDS 组较中度 ARDS 组患者 sRAGE 水平升高，PaO2/ FiO2降低，差异有统计学意义（P é0.05）。死亡组较存活组 ARDS 患者 sRAGE 水平升高，PaO2/ FiO2降低，差异有统计学意义（ P é0.05）。直线相关性分析显示，ARDS组患者 sRAGE 水平与PaO2/ FiO2呈负相关（r =-0.949，P =0.0002）。结论 sRAGE 在 ARDS 患者预后预测方面存在价值，可作为评价 ARDS 预后的一个生化标记物；在诊断方面可能存在一定价值，有待于进一步研究验证。
목적：탐토가용성만기당기화종말산물수체（sRAGE）재급성호흡군박종합정（ARDS）환자진단급예후예측중적개치。방법선취2012년3월-2013년3월입주료녕의학원부속제일의원중증감호병방적 ARDS 환자60례위 ARDS 조，근거양합지수（PaO2/ FiO2）장 ARDS 조분위경도 ARDS 조（23례）、중도 ARDS 조（23례）급중도ARDS 조（14례），근거예후분위사망조（18례）급존활조（42례）；령선택동시기입주중증감호병방적비 ARDS 환자60례위비 ARDS 조。채용매련면역흡부시험（ELISA）법검측환자혈장 sRAGE 수평，기록환자PaO2/ FiO2。결과ARDS 조교비 ARDS 조환자 sRAGE 수평승고，PaO2/ FiO2강저，차이유통계학의의（P é0.05）。불동엄중정도 ARDS 조환자 sRAGE 수평급PaO2/ FiO2비교，차이균유통계학의의（P é0.05）；기중중도 ARDS 조、중도 ARDS 조교경도 ARDS조，중도 ARDS 조교중도 ARDS 조환자 sRAGE 수평승고，PaO2/ FiO2강저，차이유통계학의의（P é0.05）。사망조교존활조 ARDS 환자 sRAGE 수평승고，PaO2/ FiO2강저，차이유통계학의의（ P é0.05）。직선상관성분석현시，ARDS조환자 sRAGE 수평여PaO2/ FiO2정부상관（r =-0.949，P =0.0002）。결론 sRAGE 재 ARDS 환자예후예측방면존재개치，가작위평개 ARDS 예후적일개생화표기물；재진단방면가능존재일정개치，유대우진일보연구험증。
Objective To discuss the application value about soluble receptor for advanced glycation end products (sRAGE)in the diagnostic and prognostic assessment of patients with acute respiratory distress syndrome(ARDS)in the inten-sive care unit(ICU). Methods 60 ARDS patients admitted to the First Affiliated Hospital of Liaoning Medical University from March 2012 to March 2013 were selected. The patients were divided into mild group(23 cases),moderate group(23 cases)and severe group(14 cases)based on oXygenation indeX(PaO2 / FiO2 ),and were divided into death group(18 cases)and survival group(42 cases). Another 60 patients admitted to ICU during the same period were selected as non - ARDS group. ELISA meth-od was used to detect sRAGE level,and the PaO2 / FiO2 was also recorded. Results Compared with the non - ARDS group,the ARDS group had higher sRAGE level and lower PaO2 / FiO2(P é 0. 05). The sRAGE level and PaO2 / FiO2 of ARDS patients with different severities showed statistically significant differences(P é 0. 05). As for the sRAGE level,the moderate group and severe group were higher than the mild group,and the severe group was higher than the moderate group and mild group,but the PaO2 / FiO2 was just the opposite(P é 0. 05). The sRAGE level in the death group was higher than the survival group,but the PaO2 / FiO2 was lower(P é 0. 05). Linear correlation analysis showed that the sRAGE level in ARDS patients was negatively cor-related with PaO2 / FiO2(r = - 0. 949,P = 0. 000 2). Conclusion Plasma sRAGE is helpful in the diagnosis and prognosis prediction in the ICU. It can be used as a prognostic biochemical marker for ARDS. It may be also helpful in the diagnosis of ARDS,but needs further study to verify.