The predictive value of the sequential organ failure score combined with Clara cell protein and angiopoietin-2 in ARDS induced by sepsis

doi:10.11958/20242304

Abstract

Abstract:

Objective To explore the predictive value of sequential organ failure score (SOFA) combined with serum Clara cell protein 16 (CC16) and angipoietin-2 (Ang-2) in the prognosis of patients with acute respiratory distress syndrome (ARDS) caused by sepsis. Methods A total of 173 sepsis patients were divided into the concurrent group (n=76) and the non-concurrent group (n=97), based on whether ARDS occurred within 72 h after admission. According to the death situation within 30 days, patients in the concurrent group were divided into the death group (n=35) and the survival group (n=41). Enzyme-linked immunosorbent assay (ELISA) was used to detect serum CC16, Ang-2, C-reactive protein (CRP) and interleukin (IL)-6. The levels of triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and white blood cell count (WBC) were detected by automatic biochemical analyzer and hemocytometer. SOFA scores were performed on patients at admission. The biochemical indexes, SOFA score, CC16 and Ang-2 levels were compared between the two groups, and the poor prognosis of the patients was analyzed. Binary Logistic regression was used for influencing factor analysis. The receiver operating characteristic (ROC) curve was used to analyze the efficacy of related factors in the poor prognosis of patients with sepsis complicated by ARDS. Results The serum levels of CRP, IL-6, CC16, Ang-2 and SOFA scores were higher in the concurrent group than those in the non-concurrent group (P<0.05). The SOFA score, mechanical ventilation time, CRP, CC16 and Ang-2 were higher in the death group than those in the survival group (P<0.05). High SOFA score, CC16 and Ang-2 were independent risk factors for poor prognosis in the concurrent group (P<0.05). The area under the curve (AUC) of SOFA score, serum CC16 and Ang-2 levels in predicting poor prognosis in patients with sepsis complicated with ARDS were 0.806 (0.700-0.888), 0.801 (0.693-0.884), 0.845 (0.743-0.918) and 0.945 (0.867-0.984), respectively. Conclusion SOFA score combined with changes in CC16 and Ang-2 expression levels can be used to comprehensively evaluate prognosis of patients with sepsis complicated with ARDS.

Key words: sepsis, respiratory distress syndrome, angiopoietin-2, uteroglobin, prognosis, ROC curve

CLC Number:

R563，R441.8

Figures/Tables 6

References 17

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组别		n	CRP/（mg/L）		IL-6/（ng/L）		TG/（mmol/L）
未并发组		97	20.83±4.85		313.32±68.41		1.62±0.42
并发组		76	24.71±5.29		351.76±71.35		1.63±0.45
t			5.018^＊		3.599^＊		0.151
组别	TC/ （mmol/L）			LDL-C/ （mmol/L）		HDL-C/ （mmol/L）		WBC/ （×10⁹/L）
未并发组	4.47±0.59			2.85±0.72		1.39±0.21		10.27±2.61
并发组	4.51±0.73			2.86±0.77		1.35±0.26		10.39±2.71
t	0.399			0.088		1.119		0.295

组别		n	CRP/（mg/L）		IL-6/（ng/L）		TG/（mmol/L）
未并发组		97	20.83±4.85		313.32±68.41		1.62±0.42
并发组		76	24.71±5.29		351.76±71.35		1.63±0.45
t			5.018^＊		3.599^＊		0.151
组别	TC/ （mmol/L）			LDL-C/ （mmol/L）		HDL-C/ （mmol/L）		WBC/ （×10⁹/L）
未并发组	4.47±0.59			2.85±0.72		1.39±0.21		10.27±2.61
并发组	4.51±0.73			2.86±0.77		1.35±0.26		10.39±2.71
t	0.399			0.088		1.119		0.295

组别	n	CC16/（μg/L）	Ang-2/（ng/L）	SOFA评分/分
未并发组	97	64.31±14.36	4.14±0.93	13.76±2.59
并发组	76	87.52±16.75	5.36±1.07	19.26±3.52
t		9.804^＊＊	8.013^＊＊	11.837^＊＊

组别	n	CC16/（μg/L）	Ang-2/（ng/L）	SOFA评分/分
未并发组	97	64.31±14.36	4.14±0.93	13.76±2.59
并发组	76	87.52±16.75	5.36±1.07	19.26±3.52
t		9.804^＊＊	8.013^＊＊	11.837^＊＊

组别	n		SOFA评分/分		机械通气时间/d		CRP/（mg/L）
生存组	41		16.63±2.51		3.85±0.92		21.29±4.61
死亡组	35		22.35±2.42		5.72±1.39		28.72±5.36
t			10.067^＊＊		7.006^＊＊		6.498^＊＊
组别		IL-6/（ng/L）		CC16/（μg/L）		Ang-2/（ng/L）
生存组		346.55±69.31		79.67±11.42		4.57±0.93
死亡组		357.86±74.27		96.71±12.75		6.28±1.15
t		0.686		6.145^＊＊		7.166^＊＊