CAJ | 학술논문

目的：探讨PRA、AngⅡ在ALI/ARDS患者中的变化和意义。方法测定ALI/ARDS和非ALI/ARDS患者血浆PRA和AngⅡ浓度，进行APACHEⅡ评分和LIS评分，计算病死率，进一步将患者按预后分组，进行比较和相关分析，利用ROC曲线评价PRA和AngⅡ的诊断分辨度。结果与非ALI/ARDS组相比，ALI/ARDS组血浆PRA和AngⅡ浓度明显增高（P＜0.05），死亡组血浆PRA和AngⅡ浓度高于存活组（P ＜0.05）。 PRA、AngⅡ与APACHEⅡ评分、LIS、乳酸（LAC）间均呈明显正相关。 PRA在预测ALI/ARDS方面有显著意义（AUC=0.705，P=0.001），AngⅡ对预测ALI/ARDS也有显著意义（AUC=0.672， P=0.007）。在预测ALI/ARDS方面，PRA、AngⅡ与LIS相比无明显差异（P=0.923，P=0.713）。结论 ALI/ARDS患者血浆PRA和AngⅡ水平明显升高，两者在预测ALI/ARDS和判断其预后方面均有重要意义，而AngⅡ在预测ALI/ARDS中的特异度较高。
목적：탐토PRA、AngⅡ재ALI/ARDS환자중적변화화의의。방법측정ALI/ARDS화비ALI/ARDS환자혈장PRA화AngⅡ농도，진행APACHEⅡ평분화LIS평분，계산병사솔，진일보장환자안예후분조，진행비교화상관분석，이용ROC곡선평개PRA화AngⅡ적진단분변도。결과여비ALI/ARDS조상비，ALI/ARDS조혈장PRA화AngⅡ농도명현증고（P＜0.05），사망조혈장PRA화AngⅡ농도고우존활조（P ＜0.05）。 PRA、AngⅡ여APACHEⅡ평분、LIS、유산（LAC）간균정명현정상관。 PRA재예측ALI/ARDS방면유현저의의（AUC=0.705，P=0.001），AngⅡ대예측ALI/ARDS야유현저의의（AUC=0.672， P=0.007）。재예측ALI/ARDS방면，PRA、AngⅡ여LIS상비무명현차이（P=0.923，P=0.713）。결론 ALI/ARDS환자혈장PRA화AngⅡ수평명현승고，량자재예측ALI/ARDS화판단기예후방면균유중요의의，이AngⅡ재예측ALI/ARDS중적특이도교고。
Objective To investigate the clinical significance and levels of plasma renin activity (PRA), Angiotensin (Ang) Ⅱ in ALI / ARDS patients. Methods The levels of PRA and AngⅡ, APACHE Ⅱ score, lung injury score(LIS), and mortality were analyzed in ALI/ARDS patients and non-ALI/ARDS group. After the patients were grouped accord-ing to prognosis, correlation analysis and ROC curve to evaluate diagnostic efficacy of PRA and AngⅡ were performed. Results Compared with non- ALI/ARDS group, the levels of PRA and AngⅡ were significantly increased in ALI/ARDS (P<0.05). In the death group, the levels of PRA and AngⅡwere higher than that of the survival group (P<0.05). It was significant positive correlation between APACHEⅡ score,LIS,lactic acid (LAC) and PRA, so as AngⅡ. In pre-dicting ALI/ARDS, PRA was significant (AUC=0.705, P=0.001), so as AngⅡ(AUC=0.672, P =0.007). In predict-ing ALI/ARDS, there was no significant difference between PRA and LIS (P=0.923), and also between AngⅡ and LIS (P = 0.713). Conclusion In ALI/ARDS patients, the levels of PRA and AngⅡwere significantly increased, and both could be used to predict ALI/ARDS and determine its prognosis, but AngⅡhad higher specificity in predicting ALI/ARDS.