波形蛋白在感染性与非感染性急性呼吸窘迫综合征患者中的表达差异及其预后价值OA
Expression difference of vimentin between infectious and non-infectious acute respiratory distress syndrome and its value for prognosis
目的 探讨波形蛋白在感染性与非感染性急性呼吸窘迫综合征患者中的表达差异及其预后价值.方法 回顾性分析2024年6月至2025年6月在宁夏回族自治区人民医院ICU住院治疗的178例ARDS患者临床资料.根据患者是否存在感染,将其分为感染性ARDS组(n=91)与非感染性ARDS组(n=87);根据患者预后(28 d是否死亡)情况,将感染性ARDS组与非感染性ARDS组患者进一步细分为存活组与死亡组.收集两组患者的一般资料、临床及实验室指标,并记录患者是否并发急性肾损伤(AKI).采用logistic回归分析相关影响因素,受试者工作特征(ROC)曲线和曲线下面积(AUC)分析预测效能.结果 感染性ARDS组身高、预计体重(PBW)、波形蛋白水平高于非感染性ARDS组,差异有统计学意义(P<0.05).与感染性存活组比较,感染性死亡组患者的驱动压(DP)、降钙素原(PCT)、IL-6、超敏C反应蛋白(hs-CRP)及波形蛋白水平明显升高,氧合指数(OI)明显降低,差异有统计学意义(P<0.05).与非感染性存活组比较,非感染性死亡组患者的DP水平明显升高,OI明显降低,差异有统计学意义(P<0.05).logistic回归分析结果显示,校正身高、PBW等混杂因素后,波形蛋白是感染性ARDS患者预后的独立影响因素(OR=2.18,95%CI:1.21~3.91,P=0.009),其预测感染性 ARDS患者预后的ROC曲线的 AUC为0.856(P=0.001),截断值为12.68 ng/mL,灵敏度为0.826,特异度为0.847.结论 血清波形蛋白对感染性ARDS患者预后具有较高的预测价值.
Objective To investigate the expression difference of vimentin between infectious and non-infectious acute respiratory distress syndrome(ARDS)and its value for prognosis.Methods Clinical data of 178 ARDS patients hospitalized in the ICU of People's Hospital of Ningxia Hui Autonomous Region from June 2024 to June 2025 were retrospectively analyzed.Patients were divided into the infectious ARDS group and the non-infectious ARDS group according to the presence or absence of infection.According to the progno-sis(28-day mortality),patients in each group were further subdivided into the survival group and the death group.General data,clinical and laboratory indicators were collected,and the occurrence of acute kidney injury(AKI)was recorded.Logistic regression analysis was used to identify related influencing factors,and receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to evaluate predictive per-formance.Results The height,predicted body weight(PBW),and vimentin level in the infectious ARDS group were significantly higher than those in the non-infectious ARDS group(P<0.05).Compared with the infectious survival group,the infectious death group had significantly higher levels of driving pressure(DP),procalcitonin(PCT),IL-6,high-sensitivity C-reactive protein(hs-CRP),and vimentin,and significantly lower oxygenation index(OI,P<0.05).Compared with the non-infectious survival group,the non-infectious death group had significantly higher level of DP and significantly lower OI(P<0.05).Logistic regression analysis showed that after adjusting for confounding factors such as height and PBW,vimentin was an independent risk factor for prognosis in patients with infectious ARDS(OR=2.18,95%CI:1.21-3.91,P=0.009).The AUC of the ROC curve for predicting prognosis in patients with infectious ARDS was 0.856(P=0.001),with a cutoff value of 12.68 ng/mL,a sensitivity of 0.826,and a specificity of 0.847.Conclusion Serum vimentin has high predictive value for the prognosis of patients with infectious ARDS.
王玉巧;周珍奉;王雅楠;张瑞祥;马静
宁夏回族自治区人民医院重症医学科,银川 750002宁夏回族自治区人民医院重症医学科,银川 750002宁夏回族自治区人民医院重症医学科,银川 750002宁夏回族自治区人民医院重症医学科,银川 750002固原市人民医院重症医学科,宁夏 固原 756000
医药卫生
急性呼吸窘迫综合征波形蛋白感染预后生物标志物
acute respiratory distress syndromevimentininfectionprognosisbiomarker
《重庆医学》 2026 (8)
1697-1702,6
宁夏自然科学基金项目(2025AAC030362,2026AAC030635)宁夏卫生健康系统科研课题(2024-NWZD-B004,2024-NWZC-A037).
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