Department of Respiratory, Hwa Mei Hospital, University of Chinese Academy of Sciences, No. 41, Xibei Street, Ningbo 315000, Zhejiang, China.
Can Respir J. 2019 Apr 1;2019:2476845. doi: 10.1155/2019/2476845. eCollection 2019.
Severe pneumonia (SP) has been widely accepted as a major cause for acute respiratory distress syndrome (ARDS), and the development of ARDS is significantly associated with increased mortality. This study aimed to identify potential predictors for ARDS development in patients with SP.
Eligible SP patients at admission from January 2013 to June 2017 were prospectively enrolled, and ARDS development within hospital stay was identified. Risk factors for ARDS development in SP patients were analyzed by univariate and multivariate logistic regression analysis. The receiver operating characteristic (ROC) curve analysis with the area under the curve (AUC) was performed for the predictive value of endocan for ARDS development.
A total of 145 SP patients were eventually enrolled into the final analysis, of which 37 developed ARDS during the hospital stay. Our final multivariate logistic regression analysis suggested plasma endocan expression as the only independent risk factor for ARDS development in SP patients (OR: 1.57, 95% CI: 1.14-2.25, =0.021). ROC curve analysis of plasma endocan resulted in an AUC of 0.754, 95% CI of 0.642-0.866, a cutoff value of 11.6 ng/mL, a sensitivity of 78.7%, and a specificity of 70.3%, respectively ( < 0.01).
Endocan expression at ICU admission is a reliable predictive factor in predicting ARDS in patients with SP.
严重肺炎（SP）已被广泛认为是急性呼吸窘迫综合征（ARDS）的主要病因，ARDS 的发展与死亡率的增加显著相关。本研究旨在确定 SP 患者中 ARDS 发展的潜在预测因素。
前瞻性纳入 2013 年 1 月至 2017 年 6 月入院的符合条件的 SP 患者，并确定住院期间 ARDS 的发展情况。采用单因素和多因素 logistic 回归分析 SP 患者 ARDS 发展的危险因素。采用受试者工作特征（ROC）曲线分析内脂素对 ARDS 发展的预测价值，并计算曲线下面积（AUC）。
共纳入 145 例 SP 患者进行最终分析，其中 37 例在住院期间发生 ARDS。我们最终的多因素 logistic 回归分析表明，血浆内脂素表达是 SP 患者 ARDS 发展的唯一独立危险因素（OR：1.57，95%CI：1.14-2.25，=0.021）。血浆内脂素的 ROC 曲线分析得出 AUC 为 0.754，95%CI 为 0.642-0.866，截断值为 11.6ng/mL，灵敏度为 78.7%，特异性为 70.3%（<0.01）。
入住 ICU 时的内脂素表达是预测 SP 患者 ARDS 的可靠预测因素。
