摘要 目的 探讨可溶性CD74（sCD74）和巨噬细胞迁移抑制因子（MIF）对脓毒症致急性呼吸窘迫综合征（ARDS）患者的临床预警价值。 方法 本研究选择2014年1月至2017年12月期间在我院重症医学科就诊的脓毒症患者92例，根据入院1周内检查结果，38例患者脓毒症合并ARDS为ARDS组，54例患者未合并ARDS为非ARDS组，ARDS组根据氧合指数（PaO2/FiO2）分为轻度、中度和重度三个亚组。入院后24 h内采集静脉血，比较两组患者以及ARDS各亚组患者血液生化指标和PaO2 /FiO2。 结果 与非ARDS组比较，ARDS组入院24 h内，PaO2 /FiO2（315.77±72.59 vs. 174.62±56.98）、PCT（ng/mL:17.12±2.83 vs. 19.57±2.79）、CRP（mg/L：148.57±112.69 vs. 227.05±139.35）、MIF（ng/mL：46.39±15.52 vs. 84.46±16.87）、sCD74（ng/mL：35.18±10.26 vs. 76.29±11.84）水平差异有统计学意义（P<0.05）。 经多因素Logistic回归分析，PaO2 /FiO2降低以及MIF、PCT、sCD74水平升高是脓毒症患者发生ARDS的独立危险因素（P<0.05）。经ROC曲线分析，外周血MIF、PCT、sCD74水平以及联合诊断的曲线下面积分别为0.769（95%CI为0.145~0.872）、0.708（95%CI为0.443~0.827）、0.667（95%CI为0.515~0.781）及0.846（95%CI为0.708~0.894），检测效能比较差异有统计学意义（χ2=19.887，P<0.05）。外周血MIF、sCD74水平与ARDS严重程度有关（P<0.05）。 结论 血清MIF、sCD74有望成为脓毒症患者发生ARDS的早期预测因子。
樊 奇，吴丰学，朱小芳. 可溶性CD74和巨噬细胞迁移抑制因子对脓毒症致急性呼吸窘迫综合征患者的临床价值分析[J]. 中国急救医学, 2019, 39(5): 457-461.
Fan Qi, Wu Feng-xue, Zhu Xiao-fang. The clinical value of sCD74 and MIF on acute respiratory distress syndrome in sepsis patients. Chinese Journal of Critical Care Medicine, 2019, 39(5): 457-461.
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