The Significance Of CLDN-4、-5in The Differential Diagnosis Of Different Types Of Pulmonary Edema

Objectives:To research the CLDN-4、-5in the differential diagnosis of different types of pulmonary edema.Methods:All pulmonary edema patients who were in ICU of Xiang Ya Hospital of Central South University were enrolled in the study.The inclusion criteria:①acute onset, chest radiograph appeared bilateral pulmonary infiltrates;②PaO2/FiO2<300mmHg.Patients were divided into three groups:increased hydrostatic pulmonary edema group increased permeability pulmonary edema group、mixed pulmonary edema group by the ICU experts. At the time of diagnosis of pulmonary edema, some clinical or laboratory data were recorded; patient serum samples were collected;according to the patient’s condition collected Bronchoalveolar lavage fluid(BALF);detecting the CLDN-4、-5by ELISA.Results:58patients were enrolled in the end,12patients in increased hydrostatic pulmonary edema group,34patients in increased permeability pulmonary edema,9patients in mixed pulmonary edema. The total numbers of serum samples were58and the BALF numbers were22. The levels of CLDN-5in serum(mean±standard deviation) in increased hydrostatic pulmonary edema group、increased permeability pulmonary edema group、mixed pulmonary edema group were172±54.6pg/ml,281.9±113.8pg/ml and537.5±194.9pg/ml (P<0.01). The levels of CLDN-4in BALF(mean±standard deviation) in increased hydrostatic pulmonary edema group、increased permeability pulmonary edema group、mixed pulmonary edema group were213.6±43.6pg/ml、29.8±1lpg/ml�'�49.2±9.7pg/ml (p<0.05).ROC curve was applied to evaluated the diagnostic value of PCT、NT-pro-BNP、CLDN-5in serum and CLDN-4in BALF. To Discriminate the increased hydrostatic pulmonary edema group and increased permeability pulmonary edema group, the area under ROC curve of PCT、NT-pro-BNP、CLDN-5in serum and CLDN-4in BALF was0.756、0.678、0.867、0.92. To Discriminate the increased mixed pulmonary edema group and increased permeability pulmonary edema group, the area under ROC curve of PCT、NT-pro-BNP、CLDN-5in serum and CLDN-4in BALF was0.634、0.875、0.911、0.929.