Objective To analyze the value of serum amyloid A(SAA) combined with polyligand proteosan-1(SDC-1) in the assessment of disease conditions and in predicting prognosis of acute respiratory distress syndrome caused by sepsis.
Methods A total of 158 patients with acute respiratory distress syndrome due to sepsis were selected as study subjects. According to the Berlin definition, the patients with acute respiratory distress syndrome were divided into mild to moderate groupoxygenation index(OI)>100 mmHg and severe group (OI≤100 mmHg). The expression levels of SAA and SDC-1 in serum of all patients were detected, and the relationships of the expression levels of SAA and SDC-1 with OI in patients with acute respiratory distress syndrome were analyzed. According to the severity of pulmonary edema, 158 patients with acute respiratory distress syndrome caused by sepsis were divided into mild pulmonary edema group (extravascular pulmonary edema edema ≤10 mL/kg) and severe pulmonary edema group (extravascular pulmonary edema edema >10 mL/kg), and the expression levels of SAA and SDC-1 in serum of patients with different degrees of pulmonary edema were compared. The prognosis of patients with acute respiratory distress syndrome after 28 days was observed and they were divided into death group and survival group according to prognosis results. The predictive efficacy of serum SAA combined with SDC-1 in predicting death of patients with acute respiratory distress syndrome was analyzed by receiver operating characteristic curve(ROC).
Results The serum levels of SAA and SDC-1 in the severe group were higher than those in mild and moderate group, and the difference was significant(P < 0.05). Pearson correlation analysis showed that the expression levels of SAA and SDC-1 in the serum of patients with acute respiratory distress syndrome were negatively correlated with OI(r=-0.951 and -0.967, P < 0.05). The levels of SAA and SDC-1 in severe pulmonary edema group were higher than those in mild pulmonary edema group (P < 0.05). Among 158 patients with acute respiratory distress syndrome, 36(22.78%) died after 28 days of treatment. The expression levels of SAA and SDC-1 in serum of the death group were higher than those of the survival group before treatment and 72 h after treatment (P < 0.05). According to ROC curve analysis, the sensitivity and specificity of serum SAA combined with SDC-1 to predict death in patients with acute respiratory distress syndrome were 92.48% and 68.09%, and the area under ROC curve(AUC) was 0.918.
Conclusion Serum SAA and SDC-1 are related to the severity of acute respiratory distress syndrome caused by sepsis, the combined effect of SAA and SDC-1 is better in predicting poor prognosis, which is worthy of further study and application.
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