[1]邱佳男,宋吉官,陈　龙,等.重症肺炎患者血清Presepsin，ICAM-1动态变化及其与预后的相关性研究[J].现代检验医学杂志,2021,36(06):166-171.[doi:10.3969/j.issn.1671-7414.2021.06.036]
　QIU Jia-nan,SONG Ji-guan,CHEN Long,et al.Dynamic Changes of Serum Presepsin and ICAM-1 in Patients with Severe Pneumonia and Their Relationship with Prognosis[J].Journal of Modern Laboratory Medicine,2021,36(06):166-171.[doi:10.3969/j.issn.1671-7414.2021.06.036]
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重症肺炎患者血清Presepsin，ICAM-1动态变化及其与预后的相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第36卷
期数:
2021年06期
页码:
166-171
栏目:
检验与临床
出版日期:
2021-12-15

文章信息/Info

Title:
Dynamic Changes of Serum Presepsin and ICAM-1 in Patients with Severe Pneumonia and Their Relationship with Prognosis
文章编号:
1671-7414（2021）06-166-06
作者:
邱佳男; 宋吉官; 陈　龙; 等
（1.辽健集团阜新矿总医院重症医学科 , 辽宁阜新 123000；2.大连市友谊医院重症医学科 辽宁大连 116001）
Author(s):
QIU Jia-nan;  SONG Ji-guan;  CHEN Long;  et al
（1.Department of Critical Care Medicine, Fuxin General Hospital of Liaojian Group, Liaoning Fuxin 123000,China;2.Department of Critical Care Medicine,Dalian Friendship Hospital, Liaoning Dalian 116001,China.）
关键词:
重症肺炎; 可溶性白细胞分化抗原14亚型; 细胞间黏附分子-1
分类号:
R563.1；R392.11
DOI:
10.3969/j.issn.1671-7414.2021.06.036
文献标志码:
A
摘要:
目的　探讨血清可溶性白细胞分化抗原14亚型（又称Presepsin）、细胞间黏附分子-1（ICAM-1）在重症肺炎中的动态变化及其与患者预后的关系。方法　选取辽健集团阜新矿总医院在2019年8月～2020年8月期间收治的重症肺炎患者89例，根据患者治疗10天后的临床归转情况分为预后良好组（n=54）以及预后不良组（n=35）。检测并对比两组患者入院时、入院3天和入院5天的血清Presepsin，ICAM-1和降钙素原（PCT）水平以及急性生理与慢性健康评分II（APACHE II）。分析重症肺炎患者血清Presepsin，ICAM-1与PCT及APACHE II评分的相关性。接受者工作特征曲线（ROC）分析各个指标对重症肺炎患者预后情况的评估价值。结果　各个时间点预后不良组的血清Presepsin，ICAM-1，PCT水平以及APACHE II评分均高于预后良好组，差异均有统计学意义（t=2.078~8.331，均P<0.05）；预后良好组的血清Presepsin，ICAM-1水平呈下降趋势，各个时间点比较差异有统计学意义（t=3.628~7.661，均P<0.05）；预后不良组的血清Presepsin，ICAM-1水平呈上升趋势，但各个时间点比较差异无统计学意义（t=1.184~1.714，均P>0.05）。各个时间点重症肺炎患者血清Presepsin与ICAM-1，PCT及APACHE II评分均呈正相关（r=0.311~0.442，均P<0.05），ICAM-1与PCT及APACHE II评分均呈正相关（r=0.302~0.374，均P<0.05）。入院5天 Presepsin和ICAM-1对重症肺炎患者预后情况的评估价值较高，曲线下面积分别为0.880（95%CI：0.802~0.957），0.843（95%CI：0.745~0.942）。结论　重症肺炎患者血清Presepsin，ICAM-1持续处于较高水平与患者预后不良相关。检测二者水平可辅助临床评估患者预后。
Abstract:
Objective　To investigate the dynamic changes of serum soluble leukocyte differentiation antigen 14 (Presepsin) and intercellular adhesion molecule-1 (ICAM-1) in patients with severe pneumonia and their relationship with prognosis. Methods　89 patients with severe pneumonia who were treated in Fuxin General Hospital of Liaojian Group from August 2019 to August 2020 were selected, and they were divided into good prognosis group (n=54) and poor prognosis group (n=35) according to the clinical outcome after 10 days of treatment. The levels of serum presepsin, ICAM-1, procalcitonin (PCT) and acute physiology and chronic health score II (APACHE II) were detected and compared between the two groups at admission, 3 days and 5 days after admission. The correlation of serum presepsin, ICAM-1 with PCT and APACHE II score in patients with severe pneumonia were analyzed. Receiver operating characteristic curve (ROC) was used to analyze the prognostic value of each index in patients with severe pneumonia. Results　At each time point, the levels of serum presepsin, ICAM-1, PCT and APACHE II score in the poor prognosis group were significantly higher than those in the good prognosis group,the differences were statistically signifcant (t=2.078~8.331, all P<0.05). The levels of serum presepsin, ICAM-1 and PCT in the good prognosis group showed a downward trend, and the difference was statistically significant at each time point (t=3.628~7.661, all P<0.05). The levels of serum presepsin, ICAM-1 and PCT in the poor prognosis group showed an upward trend, but the difference was not statistically significant at each time point (t=1.184~1.714, all P>0.05). At each time point, serum presepsin was positively correlated with ICAM-1, PCT and APACHE II scores (r=0.311~0.442, all P<0.05), and ICAM-1 was positively correlated with PCT and APACHE II scores (r=0.302~0.374, all P<0.05). Presepsin and ICAM-1 on the 5 days after admission had higher value in evaluating the prognosis of patients with severe pneumonia, and the area under the curve was 0.880 (95%CI:0.802~0.957) and 0.843 (95%CI:0.745~0.942), respectively. Conclusion 　Persistent high levels of serum presepsin and ICAM-1 in patients with severe pneumonia are associated with poor prognosis. Detection of the levels of presepsin and ICAM-1 can help to evaluate the prognosis of patients.

参考文献/References:

[1] MIZGERD J P. Pathogenesis of severe pneumonia:advances and knowledge gaps[J]. Current Opinion inPulmonary Medicine, 2017, 23(3): 193-197.
[2] GARNACHO-MONTERO J, BARRERO-GARC?AI,DE G?MEZ-PRIETO M G, et al. Severe communityacquiredpneumonia: current management and futuretherapeutic alternatives[J]. Expert Review of Anti-Infective Therapy, 2018, 16(9): 667-677.
[3] 宁永忠, 王雪茹, 程田, 等. 血清Presepsin 临床检测的研究进展[J]. 中华检验医学杂志,2019,42(8):700-704.NING Yongzhong,WANG Xueru,CHENG Tian,etal. The clinical research progress in serum Presepsin[J]. Chinese Journal of Laboratory Medicine,2019,42(8):700-704.
[4] BELLOS I, FITROU G, PERGIALIOTIS V, et al. Thediagnostic accuracy of presepsin in neonatal sepsis: ameta-analysis[J]. European Journal of Pediatrics, 2018,177(5): 625-632.
[5] ABO-HAGAR H H, ABO-ELEZZ A A E, MEHREZM, et al. Diagnostic efficacy of serum amyloid Aprotein and soluble intercellular adhesion molecule 1 inpediatric ventilator-associated pneumonia[J]. Journal ofIntensive Care Medicine, 2019, 34(6): 503-510.
[6] 中国医师协会急诊医师分会. 中国急诊重症肺炎临床实践专家共识[J].中国急救医学,2016,36(2):97-107.Chinese College of Emergency Physicans.Expertconsensus on clinical practice of emergency severepneumonia in China[J]. Chinese Journal of CriticalCare Medicine,2016,36(2):97-107.
[7] 郑贵军, 张杰根, 袁亚松, 等. 降钙素原清除率对重症肺炎患者临床转归的评估价值[J]. 中华危重病急救医学,2019,31(5):566-570.ZHENG Guijun,ZHANG Jiegen,YUAN Yasong,et al.Application value of procalcitonin clearance rate onclinical outcome in patients with severe pneumonia[J].Chinese Critical Care Medicine,2019,31(5):566-570.
[8] WANG Linlin, SONG Yuanlin. Efficacy of Zinc givenas an adjunct to the treatment of severe pneumonia:A meta-analysis of randomized, double-blind andplacebo-controlled trials[J]. The Clinical RespiratoryJournal, 2018, 12(3): 857-864.
[9] 范爱红，代育中．降钙素原及C- 反应蛋白、肿瘤坏死因子-α、白介素-6 动态监测对小儿重症肺炎病情评估及并发呼吸窘迫综合征的预测价值[J]. 临床肺科杂志,2019,24(9):1600-1605.FAN Aihong,DAI Yuzhong. Efficacy of procalcitonin( PCT) , C-reactive protein ( CRP) , tumor necrosisfactor-α( TNF-α) , and inter-leukin-6 (IL-6) dynamicmonitoring on evaluation of children with severepneumonia and prediction of acute respiratory distresssyndrome ( ARDS) [J]. Journal of Clinical PulmonaryMedicine,2019,24(9):1600-1605.
[10] KUMAR N, DAYAL R, SINGH P, et al. A comparativeevaluation of presepsin with procalcitonin and CRPin diagnosing neonatal sepsis[J]. Indian Journal ofPediatrics, 2019, 86(2): 177179.
[11] 陈静，张略．血浆Presepsin 检测在老年重症肺炎诊治中的价值研究[J]．临床误诊误治，2016，29（10）：101-103．CHEN Jing, ZHANG Lue.Study on the value of plasmapresepsin detection in the diagnosis and treatment ofelderly severe pneumonia[J]. Clinical Misdiagnosis &Mistherapy,2016,29(10):101-103.
[12] YANG H S, HUR M, YI A, et al. Prognostic valueof presepsin in adult patients with sepsis: Systematicreview and meta-analysis[J]. PLoS One, 2018, 13(1):e0191486.
[13] UGAJIN M, MATSUURA Y, MATSUURA K, et al.Impact of initial plasma presepsin level for clinicaloutcome in hospitalized patients with pneumonia[J].Journal of Thoracic Disease, 2019, 11(4): 1387-1396.
[14] 张晓鸣, 朱海涛, 常明. 血管细胞间黏附分子-1 在毛细支气管炎患儿中的表达及意义[J]. 中国当代儿科杂志,2018,20(1):43-47.ZHANG Xiaoming,ZHU Haitao,CHANG Ming.Expression of vascular intercellular adhesion molecule-1 and its significance in children with bronchiolitis[J].Chinese Journal of Contemporary Pediatrics,2018,20(1):43-47.
[15] 周洁, 吉玲, 王新华, 等. 细胞间黏附分子-1 在支气管哮喘儿童支气管黏膜中的表达及其对支气管上皮细胞凋亡的影响[J].新乡医学院学报,2019,36(2):126-130,135.ZHOU Jie,JI Ling,WANG Xinhua,et al. Expression ofintercellular adhesion molecule-1 in bronchial mucosaof asthmatic children and its effect on apoptosis ofbronchial epithelial cells [J]. Journal of XinxiangMedical University,2019,36(2):126-130,135.
[16] PERTSEVA T, KIREIEIEVA T, KRYKHTINA M,et al. Diagnostic role of systemic inflammation,blood coagulation and Padua prediction score in lungthrombosis risk estimation in hospitalized patientswith community-acquired pneumonia[J]. WiadomosciLekarskie (Warsaw, Poland : 1960), 2019, 72(2): 149-153.
[17] CHEN Tielong, ZHANG Xudong, ZHU Guangli, et al.Quercetin inhibits TNF-α induced HUVECs apoptosisand inflammation via downregulating NF-kB and AP-1signaling pathway in vitro[J]. Medicine, 2020, 99(38):e22241.
[18] 曹波, 齐小雪, 张俊梅. 维生素D3 对肺炎支原体感染小鼠肺组织ICAM-1 及IL-4 表达的影响[J]. 解剖科学进展,2018,24(5):527-529, 534.CAO Bo,QI Xiaoxue,ZHANG Junmei. Effect of vitaminD3 on ICAM-1 and IL-4 expression in lungs of miceinfected with mycoplasma pneumoniae [J].Progress ofAnatomical Sciences,2018,24(5):527-529,534.
[19] CORBACHO R M, ROCCHETTI N S, SETTECASE CJ, et al. Diagnostic value of procalcitonin in ventilatorassociatedpneumonia[J]. Medicina Clinica, 2019,152(6): 216-221.
[20] 刘振国, 王婷, 王顺达, 等. 重症肺炎并发脓毒症患者血清降钙素原、血乳酸及内毒素水平的相关研究[J]. 现代检验医学杂志,2017,32(2):95-97,164.LIU Zhenguo,WANG Ting,WANG Shunda,etal. Crelational research of the level of plasmaprocalcitonin, blood lactic acid and endotoxinin patients of severe pneumonia complicatedwith sepsis[J].Journal of Modern LaboratoryMedicine,2017,32(2):95-97,164.

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备注/Memo

备注/Memo:
作者简介：邱佳男(1983-)，男，大学本科，副主任医师，研究方向：重症医学，E-mail:qiujianan763827@163.com。
更新日期/Last Update: 1900-01-01