Screening Of Biomarkers In Peripheral Blood Of Sepsis Patients With ARDS

Objective:To study the biomarkers of peripheral blood in patients with ARDS.To screen out reliable and specific biomarkers and analyze their influence on the prognosis of sepsis patients with ARDS.Methods:The clinical data of 110 patients with sepsis who were hospitalized in ICU from November 2018 to January 2020 were collected by single center retrospective study.According to the strict inclusion and exclusion criteria,32 patients with ARDS with sepsis were finally collected.According to the prognosis,they were divided into survival group and death group.General clinical data of patients were collected,including: gender,age,state of consciousness,body temperature,respiratory rate,heart rate,blood pressure,etc.The laboratory examination data within 24 hours after admission were recorded: IL-2,IL-4,IL-6 and IL-6 10(IL-10),tumor necrosis factor-?(TNF-?),interferon-?(IFN-?),neutrophil count,lymphocyte count,platelet count,procalcitonin(PCT),blood gas analysis,brain natriuretic peptide,T lymphocyte percentage,chest CT or chest film,color Doppler echocardiography,oxygenation index(PaO2/FiO2),rapid sequential organ failure score(qSOFA)and sequential organ failure score(SOFA).And the neutrophils and lymphocytes on the day of discharge.The length of stay and prognosis were recorded.Graphpad prism 7.0 software was used for processing,and all data were tested for normality before analysis.If the measurement data conform to the normal distribution,it is expressed as mean±standard deviation,independent sample t test is used for comparison between the two groups,and Fisher exact probability method is used for comparison between the counting data.If the measurement data is non normal distribution,it is represented by median [M,(25 digit percentage,75 digit percentage)].Draw a scatter chart showing the median,25 th percentile,and 75 th percentile lines.Spss20.0 system was used for logistic regression analysis to find out the factors that may affect theprognosis of sepsis patients with ARDS.P < 0.05 was statistically significant.Results:(1)among the 32 patients with ARDS,there were 10 males,3 females,10 pulmonary infections and 3 other infections in the survival group,aged 61.77 ±14.296 years.In the death group,there were 13 males,6 females,17 pulmonary infections,2 other infections,age 66.11 ± 11.455.There was no significant difference between the two groups in terms of age,gender and infection site(P > 0.05).(2)The difference of PaO2 / FiO2 between the two groups was statistically significant(P <0.05).The AUC was 0.8057,the sensitivity and specificity were 89.47% and 69.23%,respectively.(3)Compared with the median scatter plot,the cytokines IL-6,IL-6 /IL-10,admission NLR and discharge NLR in the death group were higher.IL-10 and IFN-? were lower than those of the living.(4)Logistic regression analysis showed that PaO2 / FiO2 index(P = 0.019,or: 12.289,95% CI: 1.512-99.8)was the risk factor for prognosis of ARDS.Protective factors:IFN-?(P=0.03,or:0.161,95% CI:0.031-0.834).Conclusion:(1)PaO2/FiO2 can be used to evaluate the prognosis of sepsis patients with ARDS;(2)IFN-? can affect the prognosis of sepsis patients with ARDS,which may be a protective factor in the course of ARDS.