| Background and purposeInfluenza is an acute infectious respiratory disease.It is caused by influenza virus infection and can break out and spread in the world.Severe illness can progress to severe influenza viral pneumonia(SIVP)Continues to deteriorate,and it is easy to form respiratory distress syndrome(ARDS).ARDS is an acute critical illness of the respiratory system,which is more dangerous and has a poorer prognosis.Therefore,early identification of ARDS and prediction of disease prognosis are essential for the diagnosis and treatment of ARDS.Previous researchers have studied the important role of IL-6,TNF-? and other cytokines in the progression of ARDS and the prediction of prognosis.In recent years,studies have found that heparin binding protein(HBP)has significant bactericidal activity,chemotactic properties,and inflammation regulation.Diagnostic value.However,viral pneumonia is one of the main reasons for the formation of ARDS,and foreign studies have shown that HBP is related to respiratory dysfunction caused by influenza A virus infection.Therefore,this article mainly discusses the clinical value of HBP in assessing whether SIVP is combined with ARDS and predicting the prognosis of SI VP combined with ARDS.MethodsFrom November 2017 to February 2018,42 cases of Severe influenza viral pneumonia(SIVP)combined with ARDS patients(denoted as SIVP+ARDS group)in the income hospital of Zhengzhou University First Affiliated Hospital were selected as the research subjects.At the same time,40 patients with simple SIVP(referred to as the SIVP group)matched at the same age and gender were collected as the control group.The general data,clinical symptoms,and common hematological parameters of the two groups were compared,the value of HBP in predicting the prognosis of SIVP combined with ARDS was analyzed,and the risk factors affecting the prognosis of SIVP combined with ARDS were analyzed.All data were analyzed statistically in SPSS 22.0 statistical software.P<0.05 considered that the difference was statistically significant.Results1.Patients with SIVP and ARDS are often accompanied by dyspnea on admission.The combined bacterial infection is higher than that of patients with simple SIVP.The difference between the two groups is statistically significant(P<0.05).2.The scores of HBP,TNF-?,IL-6,CRP,PCT,PLT,D-D,and APACHE ? in SIVP combined with ARDS group were higher than those in simple SIVP group,and PaO2 and ALB were lower than those in simple SIVP group.The difference between the two groups was statistically significant(P<0.05).3.HBP,TNF-?,IL-6,APACHE ? score of patients in the worsening group of SIVP combined with ARDS group were higher than those in the improvement group,however,PaO2 and ALB were lower than those in the improvement group.The difference between the two groups was statistically significant(P<0.05).4.The correlation analysis results suggest that HBP and IL-6(r=0.417,P=0.006),TNF-?(r=0.629,P<0.001),NEUT(r=0.430,P=0.004),APACHE II score(R=0.329,P=0.033)were positively correlated,and HBP was negatively correlated with PaO2(r=-0.465,P=0.002)and ALB(r=-0.431,P=0.004).5.Multivariate logistic regression analysis showed that within 24 hours of admission,high HBP(OR value 1.100,95%CI:1.001 to 1.209,P<0.05)and high APACHE ? score(OR value 1.466,95%Cl:1.019 to 2.108,P<0.05)0.05)are the risk factors for SIVP combined with ARDS.6.In predicting outcomes in patients with SIVP and ARDS,the areas under the curve of serum HBP,IL-6,TNF-?,and APACHE ? scores were 0.868,0.764,0.689,and 0.778 respectively.When HBP,IL-6,TNF-? and APACHE ? scores with the best cut-off values of 54.04 ng/mL,199.82 pg/mL,and 15.50,the sensitivity is 82%,65%,80%,and 82%,and the specificity is 84%,84%,80%,and 64%.ConclusionSerum HBP is helpful for early assessment of patients with SIVP combined with ARDS,and also helps to predict the prognosis of patients with SIVP combined with ARDS.The best cut-off value is 54.04 ng/mL,and high serum HBP is a risk factor for SIVP patients with ARDS. |
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