血浆肝细胞生长因子对急性呼吸窘迫综合征的严重程度及预后判断的价值

目的：探讨血浆肝细胞生长因子（HGF）与急性呼吸窘迫综合征（ARDS）的严重程度的关联性及预后判断的意义.方法：应用酶联免疫吸附方法检测48例ARDS患者及30例非ARDS患者（对照组）血浆中HGF水平,根据第2 8d疾病转归将ARDS组分为生存组和死亡组,对所有患者进行急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分、序贯器官衰竭估计（SOFA）评分、肺损伤评分（LIS）,同时检测所有患者肿瘤坏死因子（TNF-α）、C-反应蛋白（CRP）水平 结果：ARDS组血浆HGF水平较对照组显著增高（P＜0.05）,ARDS死亡组血浆HGF水平显著高于生存组（P＜0.05）;HGF对ARDS患者死亡预后判断的ROC曲线下面积为0.843,以2.7 ng/mL作为最佳截断值,其灵敏度为82.9％,特异度为84.7％,优于TNF-α、CRP.结论：ARDS患者血浆中HGF水平是升高的,是临床上判断ARDS严重程度及预后的有效指标.

Value of plasma hepatocyte growth factor in predicting the severity and prognosis for patient with acute respiratory distress syndrome

Objective： To explore the relationship between the plasma hepatocyte growth factor （HGF） and severity of acute respiratory distress syndrome （ARDS） , and its prognostic significance. Methods： Plasma level of HGF was detected in 48 patients with ARDS （ARDS group） and 30 in-patients without ARDS （control group） by the method of ELISA. Patients with ARDS were further divided into non-survival group and survival group according to 28 days＇outcomes. APACHE H scores, Sequential Organ Failure Assessment score （SOFA） and lung injury score （LIS） were applied to all patients. Serum levels of tumor necrosis factor-α （TNF-α） and C reactive protein （CRP） were detected as well. Results ： The plasma level of HGF in patients with ARDS were significantly higher than that in control group （ P 〈 0.05 ）. The plasma level of HGF was higher in non-survival group than that of survival group （P 〈 0.05 ）. Furthermore, the area under the ROC curve of death outcome was 0. 843 for a cut-off value of 2.7ng/ml, with a sensitivity of 82.9% and a specificity of 84.7% , superior to TNF-α and CRP. Conclusion： Plasma level of HGF are elevated in patients with ARDS, which is a useful biomarker for predicting the severity and prognosis of ARDS under clinical situations.