The Value Of Soluble Receptor For Advanced Glycation End-Products In The Early Diagnosis Of Acute Lung Injury

Objective:To evaluate the value of soluble receptor for advanced glycation end-products in the early diagnosis of acute lung injury.Methods:27 patients with acute lung injury?ALI?from the onset to the admission time of less than 24 hours?admitted to the intensive care unit?ICU?of the second hospital of tianjin medical university from January,2018 to October,2018 were selected as the experimental group.In addition,14 patients admitted to the ICU of our hospital at the same period from the onset to the admission time of less than 24hours with Murray of 0 were selected as the control group.At the time of admission,the age,sex,infection site and basic diseases of all the selected subjects were collected.Acute Physiology and Chronic Health Evalution?APACHE-II?will be conducted within 24 hours.Peripheral venous blood and radial artery blood were collected at 1 hour,12 hours,24 hours,48 hours and 72 hours after admission.Plasma concentrations of soluble receptor for advanced glycation end-products?sRAGE?at 1h,12 h,24 h,48 h,and 72 h after admission were determined by enzyme-linked immunosorbent assay?ELISA?in venous blood.Arterial blood was analyzed for arterial blood gas to measure the oxygenation index?PaO₂/FiO₂?.Results:Plasma sRAGE levels in the acute lung injury group were significantly higher at 1 hour,12 hours,24 hours,48 hours and 72 hours after admission than in the control group?P<0.05?,and the difference was statistically significant.The average plasma sRAGE was 568.6[444.0-694.4]pg/ml in the ALI death group,and384.5[370.6-405.2]pg/ml in the ALI survival group.Compared with the two groups,the average level of plasma sRAGE in the ALI death group was higher than that in the ALI survival group,P<0.05,and the difference was statistically significant.Correlation analysis showed that the plasma sRAGE level of the ALI group was negatively correlated with the oxygenation index?PaO2/FiO2?at the corresponding time points?r>0.5,P<0.05?at 1,12,24,48 and 72 hours after admission.Baseline plasma sRAGE level of patients in ALI group was positively correlated with disease outcome?r=0.767,P<0.01?.ROC curve of plasma sRAGE level,APACHE-II score and prognosis of ALI patients shows,the area under the baseline curve of sRAGE was 0.969?95%CI 0.911-1.000?,with a critical value of424.8pg/ml,a sensitivity of 88.9%,and a specificity of 94.4%.The area under the APACHE-II score curve was 0.806?95%CI 0.632-0.98?,with a critical APACHE-II score of 26,a sensitivity of 77.8%,and a specificity of 83.3%.Compared with APACHE-II,sRAGE has higher sensitivity and specificity for the prognosis of ALI patients.Conclusions:The plasma sRAGE level of ALI patients is positively correlated with the severity of the disease and has a certain correlation with the prognosis of the disease,indicating that sRAGE can be used as a biomarker for the early diagnosis of ALI and has certain guiding significance for the prognosis of the disease.