A Study On The Change Rule Of Tuftsin In The Development Of Traumatic ARDS

Objective: To detect the changes in serum tuftsin content in patients with traumatic acute respiratory distress syndrome(ARDS)at different time and combine with the condition of patients and serum inflammatory factor content to explore the changing rule of tuftsin factor in traumatic ARDS,in order to provide reference for the diagnosis and treatment of traumatic ARDS.Methods:1)A total of 60 subjects were included in the study.The 44 cases of adult patients with mutiple trauma,and each of them was the first visit to the Affiliated Hospital of Zunyi Medical University within 24 hours after injury from 2019.07 to 2020.08 and their injury severity score(ISS)(see Annex 1-A)all greater or equal to 16.According to the Berlin ARDS diagnostic criteria(see Appendix 1-B),assess whether the patients have ARDS,and exclude those with brain trauma that affect the secretion of tuftsin factor and original respiratory diseases.At the same time,16 healthy volunteers were selected as the control group.2)To collect clinical data,collect serum samples of all subjects on day 1,4,7,and 11 and store them in the refrigerator at-80℃,and determine the patient’s serum concentration of interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-4(IL-4),interleukin-10(IL-10)and tuftsin by enzyme linked immunosorbent assay(ELISA).Results:1)The ISS score and acute physiology and chronic health evaluation-II(APACHEII)of patients with traumatic ARDS were statistically higher(P<0.05),while their ventilator using time,hospitalization time of critical care medicine Intensive care unit(ICU)and total hospitalization time are relatively longer(P<0.05);2)Compared with day 1 and 4,the serum levels of IL-1β,TNF-α,and IL-6 in patients with traumatic ARDS on day 7,11 is significantly decreased(P<0.05);IL-4 levels were significantly higher on day4,7,and 11 compared with day 1(P<0.05);IL-10 serum concentration on day7 and 11 were significantly higher than those on the 1st and 4th days(P<0.05);the tuftsin was significantly higher on the 7th and 11 th days compared with the first and 4th days,(P<0.05);3)In the early stage,the serum concentration of tuftsin was lower in patients with splenic injury and gradually higher than that in patients without spleen injury(P>0.05).As the course of the disease progressed,the patient’s oxygenation index increased,and traumatic ARDS gradually improved.4)Tuftsin level is negatively correlated with APACHE-II score,(r=-0.430,P=0.023)and positively correlated with IL-10 secretion,(r=-0.364,P=0.048);5)The main independent risk factors of traumatic ARDS were chest trauma,increased tuftsin level on the 7th day of admission,and higher APACHE-II score on admission.Conclusion:1)The tuftsin secrete by the spleen tends to gradually increase in traumatic ARDS,which may have a protective effect on the course of the disease.2)In traumatic ARDS,the secretion of tuftsin is negatively correlated with the APACHE-II score on admission,and positively correlate with the secretion of IL-10.3)Patients with higher levels of tuftsin on the 7th day of admission,higher APACHE-II score on admission,and with chest trauma,the incidence of traumatic ARDS is higher.