Department of Internal Medicine, Medical Intensive Care Unit and Division of Respiratory Diseases, 144991The Third Affiliated Hospital of Sun Yat-sen University, People's Republic of China.
Department of Emergency, 144991The Third Affiliated Hospital of Sun Yat-sen University, People's Republic of China.
Ann Clin Biochem. 2022 Sep;59(5):338-346. doi: 10.1177/00045632221103805. Epub 2022 May 28.
Acute respiratory distress syndrome (ARDS) is a severe disease with high mortality, and its primary cause is sepsis. The aim of this study was to detect and evaluate the role of Human epididymis protein 4 (HE4) in sepsis-related ARDS.
One hundred and twenty-three critically ill sepsis patients with/without ARDS and 102 healthy controls were enrolled in this study. Blood samples were collected upon admission for quantitative testing of HE4 by chemiluminescent microparticle immunoassay (CMIA). ROC curve analysis and Spearman's correlation analysis were conducted to determine the diagnostic and prognostic value of HE4.
Compared with controls, the serum HE4 concentrations of sepsis patients were elevated, and levels in sepsis patients with ARDS were significantly higher (all < 0.0001). Moreover, HE4 concentrations were strongly correlated with the clinical severity characteristics of sepsis patients, and ROC curve suggested that the AUC of HE4 applied to discriminate sepsis-ARDS patients from sepsis patients was 0.903. HE4 was also found to be a prognostic biomarker of clinical severity and 28-day mortality among critically ill sepsis patients. Logistic regression analysis showed that HE4 was an independent factor for diagnosis of ARDS. Meanwhile, ROC curve analysis showed that the cut-off value of serum HE4 to discriminate 28-day mortality from sepsis patients (AUC: 0.782) was 646.5 pmol/L.
The concentration of serum HE4 in patients with sepsis-related ARDS was markedly increased and was significantly correlated with mortality, which suggests that serum HE4 could be a promising diagnostic and prognostic biomarker for ARDS in sepsis patients.
急性呼吸窘迫综合征（ARDS）是一种死亡率很高的严重疾病，其主要病因是脓毒症。本研究旨在检测并评估人附睾蛋白 4（HE4）在脓毒症相关 ARDS 中的作用。
本研究纳入了 123 例患有/不患有 ARDS 的危重症脓毒症患者和 102 名健康对照者。入院时采集血样，采用化学发光微粒子免疫分析（CMIA）定量检测 HE4。通过 ROC 曲线分析和 Spearman 相关分析来确定 HE4 的诊断和预后价值。
与对照组相比，脓毒症患者的血清 HE4 浓度升高，且 ARDS 患者的浓度明显更高（均<0.0001）。此外，HE4 浓度与脓毒症患者的临床严重程度特征密切相关，ROC 曲线提示 HE4 用于区分脓毒症-ARDS 患者与脓毒症患者的 AUC 为 0.903。HE4 还被发现是危重症脓毒症患者临床严重程度和 28 天死亡率的预后生物标志物。Logistic 回归分析显示，HE4 是 ARDS 诊断的独立因素。同时，ROC 曲线分析显示，区分脓毒症患者 28 天死亡率的血清 HE4 截断值（AUC：0.782）为 646.5 pmol/L。
脓毒症相关 ARDS 患者血清 HE4 浓度明显升高，与死亡率显著相关，这表明血清 HE4 可能是脓毒症患者 ARDS 的有前途的诊断和预后生物标志物。
