血清肺表面活性蛋白D和脂多糖结合蛋白对呼吸机相关性肺炎患者短期内撤机的预测价值OA
Predictive Value of Serum Surfactant Protein D and Lipopolysaccharide-Binding Protein for Short-Term Weaning in Patients with Ventilator-Associated Pneumonia
目的 探讨血清肺表面活性蛋白D(SP-D)和脂多糖结合蛋白(LBP)水平对呼吸机相关性肺炎(VAP)患者短期内成功撤机的预测价值.方法 回顾性选取2022年6月至2025年6月河北省第八人民医院收治的172例VAP患者作为研究对象,根据7 d内撤机结局将患者分为撤机成功组(104例)与撤机失败组(68例).所有患者于确诊VAP后24 h内采集静脉血,检测血清SP-D、LBP水平.比较两组血清SP-D、LBP水平及临床资料;采用受试者工作特征(ROC)曲线分析血清SP-D、LBP水平对VAP患者短期内成功撤机的预测效能;采用多因素Logistic回归分析VAP患者短期内成功撤机的影响因素.结果 撤机失败组患者血清SP-D、LBP水平均高于撤机成功组(P<0.05).血清SP-D、LBP预测VAP患者短期内成功撤机的曲线下面积分别为0.731(95%CI:0.686～0.781)、0.798(95%CI:0.753～0.848),二者联合预测的曲线下面积为0.902(95%CI:0.857～0.952).撤机失败组ICU入住时间、机械通气时间、合并糖尿病、吸烟比例高于撤机成功组(P<0.05).多因素Logistic回归分析显示,ICU入住时间(OR=1.857,95%CI:1.083～3.184)、机械通气时间(OR=2.079,95%CI:1.070～4.041)、血清SP-D(OR=2.606,95%CI:1.717～3.957)、血清LBP(OR=2.649,95%CI:1.776～3.950)是VAP患者短期内成功撤机的独立影响因素(P<0.05).结论 血清SP-D和LBP可作为预测VAP患者短期撤机结局的有效生物标志物,二者联合应用有助于提高预测效能.
Objective To explore the predictive value of serum pulmonary surfactant protein D(SP-D)and lipopolysaccharide binding protein(LBP)levels for short-term successful weaning in patients with ventilator-associated pneumonia(VAP).Methods A retrospective study was conducted on 172 patients with VAP admitted to the Eighth People's Hospital of Hebei Province from June 2022 to June 2025.The patients were divided into a successful weaning group(104 cases)and a failed weaning group(68 cases)based on the weaning outcome within 7 days.Venous blood was collected from all patients within 24 hours after the diagnosis of VAP,and serum SP-D and LBP levels were measured.The serum levels of SP-D and LBP and clinical data were compared between the two groups.The predictive efficacy of serum SP-D and LBP levels for short-term successful weaning in patients with VAP was analyzed using the receiver operating characteristic curve.Multivariate logistic regression analysis was used to identify the influencing factors for short-term successful weaning in patients with VAP.Results The serum levels of SP-D and LBP in the failed weaning group were higher than those in the successful weaning group(P<0.05).The area under the curve(AUC)of serum SP-D and LBP for predicting short-term successful weaning in patients with VAP was 0.731(95%CI:0.686-0.781)and 0.798(95%CI:0.753-0.848),respectively,and the AUC of their combined prediction was 0.902(95%CI:0.857-0.952).The failed weaning group had longer ICU stay and mechanical ventilation time,and higher proportions of patients with diabetes and smoking history than the successful weaning group(P<0.05).Multivariate logistic regression analysis showed that ICU stay(OR=1.857,95%CI:1.083-3.184),mechanical ventilation time(OR=2.079,95%CI:1.070-4.041),serum SP-D(OR=2.606,95%CI:1.717-3.957),and serum LBP(OR=2.649,95%CI:1.776-3.950)were independent influencing factors for short-term successful weaning in patients with VAP(P<0.05).Conclusion Serum SP-D and LBP can serve as effective biological indicators for predicting short-term weaning outcomes in patients with VAP,and their combined application may help improve the predictive efficacy.
崔雪琴;焦红蕾;李红敏;柳宁;刘影;赵博雅;田利红
河北省第八人民医院中西医结合科,石家庄 050000河北省第八人民医院中西医结合科,石家庄 050000河北省第八人民医院中西医结合科,石家庄 050000河北省第八人民医院中西医结合科,石家庄 050000河北省第八人民医院中西医结合科,石家庄 050000河北省第八人民医院中西医结合科,石家庄 050000河北省第八人民医院中西医结合科,石家庄 050000
肺炎,呼吸机相关性肺表面活性蛋白D脂多糖结合蛋白预测
pneumonia,ventilator-associatedsurfactant protein Dlipopolysaccharide-binding proteinprognosis
《转化医学杂志》 2026 (5)
747-751,5
河北省中医药管理局科研计划项目(2025361)
评论