Crit Care:透明质酸与急性呼吸窘迫综合征的器官功能障碍!

2017-12-15 xing.T MedSci原创

由此可见,肺泡中HA水平升高与LIS相关,而循环中HA水平与肺损伤和SOFA评分相关。这些发现提示HA在ARDS患者的局部和全身器官功能障碍中发挥潜在的作用。

透明质酸(HA)(细胞外基质成分)在局部组织损伤或应激时被降解。在各种肺损伤动物模型中,HA已被证明在调节炎症和损伤中发挥重要作用。虽然HA存在于急性呼吸窘迫综合征(ARDS)患者的肺组织中,但其与患者结局之间的关系尚不清楚。近日,危重病医学领域权威杂志Critical Care上针对这一问题发表了一篇研究文章。

研究人员分析了在五家北美医疗中心进行的急性肺损伤患者鱼油二期随机试验(NCT00351533)的86例ARDS患者。研究人员检查了患者诊断ARDS后48小时内获得的配对血清和支气管肺泡灌洗液(BALF)样品。通过调整年龄、性别、种族、治疗分组和ARDS的危险因素后,研究人员采用回归分析评估了血清和BALF中HA水平与器官功能障碍的局部(肺损伤评分(LIS))和全身性(器官衰竭评估评分(SOFA)指标之间的相关性。

研究人员发现在0天时循环中和肺泡中HA水平与LIS恶化相关(分别为P=0.04和P=0.003),特别是与低氧血症程度(分别为P=0.02和P<0.001)以及呼气末正压(分别为P=0.01和P=0.02)相关联。循环HA与SOFA评分(P<0.001)相关,主要由呼吸系统(P=0.02)、凝血系统(P<0.001)、肝脏(P=0.006)和肾脏(P=0.01)成分相关。值得注意的是,肺泡HA水平与SOFA评分中的呼吸组分相关(P=0.003),而与复合SOFA评分(P=0.27)无关。

由此可见,肺泡中HA水平升高与LIS相关,而循环中HA水平与肺损伤和SOFA评分相关。这些发现提示HA在ARDS患者的局部和全身器官功能障碍中发挥潜在的作用。

原始出处:

Anthony J. Esposito,et al. Hyaluronic acid is associated with organ dysfunction in acute respiratory distress syndrome.Critical Care.2017. https://doi.org/10.1186/s13054-017-1895-7

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    2017-12-15 1ddf0692m34(暂无匿称)

    学习了.好文章

    0

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