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[1]尹小芳,孟月,傅元冬,等.血清铁蛋白与急性呼吸窘迫综合征的相关性[J].医学研究与战创伤救治(原医学研究生学报),2022,24(3):242-247.[doi:10.3969/j.issn.1672-271X.2022.03.004]
　YIN Xiao-fang,MENG Yue,FU Yuan-dong,et al.Correlation between serum ferritin and acute respiratory distress syndrome[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2022,24(3):242-247.[doi:10.3969/j.issn.1672-271X.2022.03.004]
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血清铁蛋白与急性呼吸窘迫综合征的相关性()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第24卷
期数:
2022年3期
页码:
242-247
栏目:
临床研究
出版日期:
2022-06-30

文章信息/Info

Title:
Correlation between serum ferritin and acute respiratory distress syndrome
作者:
尹小芳; 孟月; 傅元冬; 朱桂松; 许飚
作者单位：210001南京，南京中医药大学附属南京中医院重症医学科（尹小芳、孟月、傅元冬、朱桂松、许飚）
Author(s):
YIN Xiao-fang;  MENG Yue;  FU Yuan-dong;  ZHU Gui-song;  XU Biao
(Intesnsive Care Unit, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210001, Jiangsu, China)
关键词:
急性呼吸窘迫综合征; 铁蛋白; 诊断; 严重程度; 预后
Keywords:
acute respiratory distress syndrome; ferritin; diagnosis; severity;  prognosis
分类号:
R563.8
DOI:
10.3969/j.issn.1672-271X.2022.03.004
文献标志码:
A
摘要:
目的分析急性呼吸窘迫综合征（ARDS）患者血清铁蛋白水平变化，探讨血清铁蛋白对ARDS诊断、严重程度及预后的评估价值。方法回顾性分析2019年12月至2021年12月在南京中医药大学附属南京中医院综合重症监护病房（ICU）住院的危重症患者106例的临床资料。收集所有患者入ICU第2天的血清铁蛋白、降钙素原（PCT）、白细胞介素-6（IL-6）、C反应蛋白（CRP）、白细胞、急性生理与慢性健康评分（APACHE Ⅱ评分）、序贯性器官功能衰竭评分（SOFA），并记录患者的一般人口学资料、基础疾病、ICU住院时间、临床转归等。统计分析血清铁蛋白水平与ARDS严重程度的关系，采用受试者工作特征（ROC）曲线分析血清铁蛋白对ARDS诊断及预后的评估价值。结果97例患者纳入统计分析，其中ARDS患者60例（61.86%）。ARDS患者的血清铁蛋白水平显著高于非ARDS患者[934.25（564.43～1650.00）ng/mL vs 261.30（115.90～395.25）ng/mL，P<0.001]。高血清铁蛋白（≥615.3 ng/mL）组的重度ARDS患者比例显著高于低血清铁蛋白组（26.53% vs 6.25%，P<0.01），且随着ARDS严重程度的增加，高血清铁蛋白患者所占的百分比也随之增加(分别为34.78%、42.86%、81.25%，P<0.01）。ROC曲线分析显示：血清铁蛋白水平＞544 ng/mL时，预测ARDS诊断的灵敏度和特异度分别为78.3%、86.5%（曲线下面积=0.83，95%CI=0.74～0.92，P＜0.001)；血清铁蛋白水平＞972.7 ng/mL时，预测ARDS患者28 d病死的灵敏度和特异度分别为79.3%、83.9%（曲线下面积=0.84，95%CI=0.74～0.95，P＜0.001)。结论血清铁蛋白水平不仅与ARDS的严重程度有关，而且对ARDS的诊断和预后评估均具有良好的预测价值。
Abstract:
ObjectiveTo analyze the change of serum ferritin level in patients with acute respiratory distress syndrome (ARDS), and to study the evaluation value of serum ferritin in the diagnosis, severity and prognosis of ARDS.MethodsA total of 106 critically ill patients hospitalized in the comprehensive intensive care unit (ICU) of our hospital from December 2019 to December 2021 were analyzed retrospectively. The serum ferritin, procalcitonin (PCT), interleukin-6 (IL-6), C-reactive protein (CRP), leukocytes, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, sequential organ failure assessment (SOFA) of all enrolled patients were collected on the second day after entering ICU. The general demographic data, basic diseases, ICU hospitalization time and clinical outcome were also recorded. The correlation between serum ferritin level and the severity of ARDS was analyzed. The evaluation value of serum ferritin in the diagnosis and prognosis of ARDS was also analyzed by receiver operating characteristic (ROC) curve.Results9 patients were lost to follow up. Among the 97 patients, 60 cases (61.86%) were diagnosed as ARDS. The serum ferritin in ARDS patients was significantly higher than that in non-ARDS patients [934.25（564.43-1650.00）ng/mL vs 261.30（115.90-395.25）ng/mL，P<0.001]. The proportion of patients with severe ARDS in high serum ferritin (≥615.3 ng/mL) group was significantly higher than that in low serum ferritin group (26.53% vs 6.25%, P<0.01). In addition, as the severity of ARDS increased, the percentage of patients with elevated serum ferritin also increased (34.78%, 42.86%, 81.25%, respectively, P<0.01). Depending on the ROC curve analysis, serum ferritin could identify ARDS patients with sensitivity of 78.3% and specificity of 86.5%（AUC=0.83, 95%CI=0.74-0.92, P＜0.001). ROC curve analysis also showed that serum ferritin could predict 28-day mortality in ARDS patients with sensitivity of 79.3% and specificity of 83.9% (AUC=0.84, 95%CI=0.74-0.95, P＜0.001).ConclusionSerum ferritin level not only is related to the severity of ARDS, but also has good predictive value for the diagnosis and prognosis of ARDS.

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备注/Memo

备注/Memo:
基金项目：南京市医学科技发展项目（YKK20165）
更新日期/Last Update: 2022-06-21