血浆 sRAGE、Nampt 水平与呼吸机相关性 肺炎患者病情程度和预后的关系.

Objective To investigate the relationships between the levels of plasma soluble receptor for advanced glycation end products (sRAGE) and nicotinamide phosphoribosyltransferase (Nampt) and the severity and prognosis of patients with ventilator-associated pneumonia (VAP) . Methods Totally 143 VAP patients (observation group) were selected. According to the degree of disease, they were divided into 38 severe cases, 49 moderate cases, and 56 mild cases. During the follow-up period of 28 days, 41 cases died and 102 cases survived. During the same period, 50 healthy volunteers (control group) were selected. The elbow vein blood was collected, and the plasma was centrifuged to determine the plasma sRAGE and Nampt. The plasma sRAGE and Nampt levels in the observation group, the control group and VAP patients with different conditions were compared, and the relationships between the plasma sRAGE and Nampt levels in the VAP patients and the acute physiology and chronic health assessment Ⅱ (APACHE Ⅱ) score were analyzed. The clinical data of VAP patients were collected, and the influencing factors of poor prognosis were analyzed. Plasma sRAGE and Nampt levels in all subjects were determined by ELISA. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of plasma sRAGE and Nampt levels for poor prognosis in VAP patients. Results The plasma levels of sRAGE and Nampt in the observation group were significantly higher than those in the control group (both P<0. 01) . With the aggravation of VAP, the levels of plasma sRAGE and Nampt gradually increased (both P<0. 01) . Plasma sRAGE and Nampt levels in VAP patients were positively correlated with APACHE Ⅱ score (both P<0. 01) . Multivariate Logistic regression analysis showed that age ≥60 years, mechanical ventilation time ≥72 h, history of diabetes, tracheotomy, ≥2 lesions involving lobes, APACHE Ⅱ score, sRAGE, and Nampt were independent risk factors for poor prognosis in VAP patients, while mean arterial pressure ≥65 mmHg was an independent protective factor (all P<0. 05) . The area under the ROC curve of plasma sRAGE combined with Nampt levels in predicting poor prognosis of VAP patients was significantly higher than that of plasma sRAGE and Nampt levels alone (both P<0. 05). Conclusions Plasma sRAGE and Nampt levels significantly increase in VAP patients, and their elevated levels are closely related to disease severity and prognosis. Plasma sRAGE and Nampt levels are independent risk factors for poor prognosis in VAP patients, and can be used as biomarkers to predict poor prognosis in VAP patients. [ABSTRACT FROM AUTHOR]