可溶性CD74和巨噬细胞迁移抑制因子对脓毒症致急性呼吸窘迫综合征患者的临床价值分析

doi:10.3969/j.issn.1002-1949.2019.05.012

Chinese Journal of Critical Care Medicine

2019, Vol. 39

Issue (5): 457-461 DOI: 10.3969/j.issn.1002-1949.2019.05.012

The clinical value of sCD74 and MIF on acute respiratory distress syndrome in sepsis patients

Fan Qi, Wu Feng-xue, Zhu Xiao-fang

Department of Emergency, Jingzhou Central Hospital of Hubei Province, Jinzhou 434020, China

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Abstract Objective To investigate the predictive value of soluble CD74 (sCD74) and macrophage migration inhibitory factor (MIF) on acute respiratory distress syndrome (ARDS) in sepsis patients. Methods 92 sepsis patients in our hospital were selected from January 2014 to December 2017 and divided into ARDS group (n=38) and non-ARDS group (n=54). The blood samples were collected within 24 h after diagnosis of sepsis. The levels of plasma PCT, CRP, MIF, sCD74, IL-6, TNF-α and PaO2/FiO2 were detected and compared between the two groups. Results There was statistical difference of the baseline values of PaO2 /FiO2（315.77±72.59 vs. 174.62±56.98），PCT（ng/mL:17.12±2.83 vs. 19.57±2.79），CRP（mg/L：148.57±112.69 vs. 227.05±139.35），MIF（ng/nL：46.39±15.52 vs. 84.46±16.87）and sCD74（ng/mL：35.18±10.26 vs. 76.29±11.84）between ARDS group and non-ARDS group (P<0.05). The low PaO2 /FiO2 and high level of PCT, MIF, sCD74 were independent risk factors of ARDS in patients with sepsis by Logistic regression analysis (P<0.05). The AUC of ROC curve of PCT combined with MIF and sCD74 was 0.846 (95%CI708-0.894), which was more than the AUC of PCT, MIF, sCD74 alone［0.769 (95%CI 0.145-0.872), 0.708 (95%CI0.443-0.827), 0.667 (95%CI0.515-0.781)］(χ2=19.887, P<0.05). The plasma MIF, sCD74 levels of sepsis patients with ARDS were correlated with disease severity (P<0.05). Conclusion It suggests that MIF and sCD74 combined with PCT are sensitive predictors of ARDS in elderly patients with sepsis. 

Key words： Sepsis Acute respiratory distress syndrome（ARDS） Migration inhibitory factor（MIF） sCD74 Diagnosis

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Fan Qi,Wu Feng-xue,Zhu Xiao-fang. The clinical value of sCD74 and MIF on acute respiratory distress syndrome in sepsis patients[J]. Chinese Journal of Critical Care Medicine, 2019, 39(5): 457-461.

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2019.05.012 OR http://www.cnemergency.org.cn/EN/Y2019/V39/I5/457

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