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Determination of serum pulmonary surfactant protein A and its significance in patients with acute lung injury
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- Author:
- No author available
- Journal Title:
- CHINESE CRITICAL CARE MEDICINE
- Issue:
- 1
- DOI:
- 10.3760/j.issn:1003-0603.2000.01.004
- Key Word:
- 肺损伤,急性;预后;乳酸脱氢酶;肺表面活性物质蛋白A
Abstract： 目的:动态观测急性肺损伤(ALI)患者血清肺表面活性物质蛋白A(SP-A)的变化,并探讨其临床意义.方法:选择符合ALI诊断标准并已给予机械通气治疗的患者20例,于入组时和出组时(即脱机或死亡之前)抽取静脉血,多数患者在观察期间病情有明显变化时重复抽血,共收集静脉血标本71例次;并同时记录动脉血气测值和呼吸机参数,计算动脉血氧分压(PaO2)与吸入气氧浓度(FiO2)比值和静态总呼吸顺应性(TRC).健康对照组22例也留取血清,用免疫印迹法测定SP-A浓度.结果:ALI组患者入组时血清SP-A浓度显著高于对照组(P<0.001);ALI患者中8例最终死于急性呼吸窘迫综合征(ARDS)合并多器官功能衰竭(MOF)患者SP-A浓度明显高于10例最终存活者(P<0.01).8例死于ARDS合并MOF的ALI患者出组时,血清SP-A浓度显著高于10例存活者及其入组时测值(P<0.005和P<0.05),而10例存活者SP-A浓度明显低于其入组时测值(P<0.001).整个观察期间ALI患者血清SP-A浓度与其相应的PaO2/FiO2和TRC呈负相关(P均<0.001).结论:ALI患者血清中SP-A浓度显著升高,SP-A水平与患者的肺损伤严重程度和预后密切相关.
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