关键词: 脓毒症, 肺损伤, 平足蛋白, 炎症反应, 巨噬细胞

Abstract: Objective To study the clinical value of plasma soluble podoplanin(sPDPN) in the early diagnosis, severity and prognosis evaluation for the elderly patients with septic lung injury. Methods A total of 95 elderly patients with sepsis admitted to Department of ICU, Wuxi People's Hospital from January 2018 to December 2020 were selected and divided into sepsis group(n=40) and septic lung injury group(n=55). The patients in the septic lung injury group were subdivided into sepsis combined with acute respiratory distress syndrome(ARDS) subgroup(n=29) and septic shock combined with ARDS subgroup(n=26) according to the severity of the complications, and were subdivided into survival subgroup(n=40) and death subgroup(n=15) according to the 28-d outcome. Thirty healthy subjects from physical examination center of our hospital during the same period were enrolled in control group. The general condition, APACHE Ⅱ score, SOFA score and extravascular lung water(EVLW) were observed and recorded, and the levels of C-reactive protein(CRP), procalcitonin(PCT), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α) and sPDPN were detected on the day of admission to ICU. Results The expression level of sPDPN, the levels of CRP, PCT, IL-6 and TNF-α, SOFA score and APACHE Ⅱ score showed statistical differences among all the groups and subgroups(P<0.05). The level of sPDPN was positively correlated with the above inflammatory indexes, EVLW, SOFA score and APACHE Ⅱ score in each group. The area under the curve(AUC) of receiver operator characteristic(ROC) of sPDPN in predicting the outcome of the septic lung injuny patients was 0.867. Conclusions sPDPN is a potentially valuable target for early diagnosis, evaluation of disease condition and prognosis, and selection of possible therapeutic targets in the patients with sepsis combined with acute lung injury.

Key words: sepsis, lung injury, podoplanin, inflammatory response, macrophage