Change of Angiopoietin-1 in the Peripheral Blood of Patients with Acute Respiratory Distress Syndrome and Its Relationship with Prognosis / 华中科技大学学报(医学版)

ABSTRACT

Objective To investigate the change of angiopoietin‐1(Ang‐1)in the peripheral blood of patients with acute re‐spiratory distress syndrome and its relationship with prognosis.Methods A total of 85 hospitalized patients with ARDS were recruited and divided into mild group(n=25) ,moderate group(n=36)and severe group(n=24)according to the oxidation states of patients.Another 40 hospitalized patients without ARDS were included as the control group.The basic clinical data of all pa‐tients were obtained.The expressions of Ang‐1 and Tie2 in the peripheral blood were detected by RT‐PCR.The correlation be‐tween the different variables was analyzed by using Pearson correlation analysis.All patients were divided into survival group(n=47)and death group(n=38)according to the deaths of patients after 28 days.The relevant factors for prognostic of patients with ARDS were analyzed by using multivariate Logistic regression analysis.The effectiveness of Ang‐1 in predicting ARDS was analyzed by using ROC curves.Results In ARDS patients relative to the control patients ,PaO2/FiO2 was decreased ,A‐PACHEⅡ score ,LIS score ,SOFA score ,C‐reactive protein(CRP) ,IL‐6 ,and mortality rates were increased ,and the relative ex‐pressions of Ang‐1 mRNA and Tie2 mRNA in the peripheral blood were decreased ,with the differences being statistically sig‐nificant(P0.05).ROC curve analysis showed that when the relative expression of Ang‐1 mRNA was used for the diagnosis of ARDS ,the area under the curve was 0.874(95% CI0.809-0.938) ,the sensitivity was 72.5% ,and the specificity was 85.9% . Conclusion Down‐expression of Ang‐1 in the peripheral blood of patients with ARDS is closely related with the severity of the patient’s condition.It may accelerate the endothelial cell damage and increase the vascular permeability by reducing the binding to Tie2.It may be used as a prognostic indicator for patients with ARDS.