Xie Yongpeng, Wang Yangli, Liu Kexi, Li Xiaomin
Department of Critical Care Medicine.
Department of Emergency Medicine, Lianyungang Clinical College of Nanjing Medical University, The First People's Hospital of Lianyungang City, Lianyungang, China.
Medicine (Baltimore). 2019 Jul;98(29):e16531. doi: 10.1097/MD.0000000000016531.
To identify the clinical correlations between mechanical power and transforming growth factor-β1 (TGF-β1) and connective tissue growth factor (CTGF) in acute respiratory distress syndrome (ARDS) patients, their clinical significance in pulmonary structural remodeling in ARDS patients was investigated.
Ninety-five patients with moderate or severe ARDS, who required mechanical ventilation therapy, were randomly selected among hospitalized patients from January 2017 to February 2019. Their mechanical power was monitored and recorded, the TGF-β1 and CTGF levels were detected by enzyme-linked immunosorbent assay (ELISA), their relevance was analyzed, and the relationship between mechanical power and 28-day survival rate was investigated. According to the high-resolution computed tomography (HRCT) examination, the patients were divided into an ARDS group and an ARDS pulmonary fibrosis (ARDS-PF) group. The differences in mechanical power, TGF-β1, and CTGF between the 2 groups were compared, and the significance of TGF-β1 and CTGF in the diagnosis of ARDS pulmonary interstitial fibrosis were evaluated.
A significant positive correlation between mechanical power and serum TGF-β1 and CTGF in patients with ARDS was found and the correlation coefficients were 0.424 and 0.581, respectively. The difference between mechanical power and 28-day survival rate was statistically significant (P < .05), while the area under the receiver operating characteristic curves of TGF-β1 and CTGF for the diagnosis of ARDS pulmonary fibrosis was 0.838 and 0.884, respectively (P < .05).
A significant correlation between mechanical power and serum fibrosis biomarkers TGF-β1 and CTGF in ARDS patients was found, and its level was related to the survival prognosis of patients. Mechanical power, TGF-β1, and CTGF were clinically evaluated for the assessment of lung structural remodeling, such as ARDS pulmonary fibrosis. This study has particular significance to the early prevention of ventilator-induced lung injury and pulmonary fibrosis in patients with ARDS receiving mechanical ventilation.
为明确急性呼吸窘迫综合征（ARDS）患者机械功率与转化生长因子-β1（TGF-β1）及结缔组织生长因子（CTGF）之间的临床相关性，研究其在ARDS患者肺结构重塑中的临床意义。
选取2017年1月至2019年2月住院的95例需要机械通气治疗的中重度ARDS患者。监测并记录其机械功率，采用酶联免疫吸附测定（ELISA）法检测TGF-β1和CTGF水平，分析其相关性，并研究机械功率与28天生存率的关系。根据高分辨率计算机断层扫描（HRCT）检查结果，将患者分为ARDS组和ARDS肺纤维化（ARDS-PF）组。比较两组患者机械功率、TGF-β1和CTGF的差异，评估TGF-β1和CTGF在ARDS肺间质纤维化诊断中的意义。
ARDS患者机械功率与血清TGF-β1和CTGF之间存在显著正相关，相关系数分别为0.424和0.581。机械功率与28天生存率的差异具有统计学意义（P<0.05），而TGF-β1和CTGF诊断ARDS肺纤维化的受试者工作特征曲线下面积分别为0.838和0.884（P<0.05）。
发现ARDS患者机械功率与血清纤维化生物标志物TGF-β1和CTGF之间存在显著相关性，其水平与患者的生存预后相关。对机械功率、TGF-β1和CTGF进行临床评估，有助于评估肺结构重塑，如ARDS肺纤维化。本研究对接受机械通气的ARDS患者早期预防呼吸机相关性肺损伤和肺纤维化具有特殊意义。
