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| The correlations analysis between mechanical power and biomarker TGF-β1, CTGF in ARDS patients and their clinical significance research in pulmonary structural remodeling |
| Xie Yong-peng, Qian Ying, Liu Ke-xi, Liu Su-xia, Zheng Hui, Cao Li-juan, Li Xiao-min |
| Department of Critical Care Medicine, Xuzhou Medical University Affiliated Hospital of Lianyungang, Lianyungang 222000, China |
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Abstract Objective To investigate the clinical correlations between mechanical power and biomarker TGF-β1, CTGF in ARDS patients, and their clinical significance in pulmonary structural remodeling and analyze the evaluation value of prognosis in ARDS patients. Methods Eighty-five patients with moderate or severe ARDS who need mechanical ventilation therapy were randomly selected from hospitalized patients from January 2017 to January 2019. They were monitored and recorded mechanical power, and their serum lung fiber markers TGF-β1, CTGF were detected by ELISA. According to the HRCT examination, the patients were divided into the ARDS group and the ARDS pulmonary fibrosis group. The differences in mechanical power, TGF-β1 and CTGF between the two groups were compared; their relevance was analyzed and TGF-β1 and CTGF was evaluated for the diagnosis of ARDS pulmonary interstitial fibrosis. According to the median value of mechanical power, the patients were divided into high mechanical power group and low mechanical power group, and then were investigated the relationship between mechanical power and patient 28-day survival rate. Results The mechanical power of the ARDS group was (16.91±3.26) J/min, the TGF-β1 was (13.20±5.91) ng/mL, the CTGF was (44.60±14.82) ng/mL, the mechanical power of the ARDS pulmonary fibrosis group was (22.20±4.42) J/min, and the TGF-β1 was (22.82±9.97) ng/mL, CTGF was (70.18±20.27) ng/ml, the difference between the two groups was significant ( P <0.001); There was a significant positive correlation between mechanical power and serum TGF-β1, CTGF in patients with ARDS, and the correlation coefficients were 0.411 and 0.565, respectively ( P < 0.001). Statistical analysis of the high mechanical power group and low mechanical power group in the 28-day survival rate showed that the high mechanical power group survival rate was 51.06%, and the low mechanical power group survival rate was 72.12%, the difference was statistically significant ( P <0.05). The area under the ROC curve of TGF-β1 and CTGF for the diagnosis of ARDS pulmonary fibrosis was 0.800 and 0.837, respectively, the significance was significant ( P <0.05). Conclusion There was a significant correlation between mechanical power and serum fibrosis biomarkers TGF-β1, CTGF in ARDS patients, and its level was related to the survival prognosis of patients. The three were clinically evaluated for the assessment of lung structural remodeling such as ARDS pulmonary fibrosis. The three indicators have significant clinical value in evaluating the changes of lung structure remodeling such as ARDS pulmonary fibrosis.
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Corresponding Authors:
Li Xiao-min, E-mail: lyglxm1@163.com
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