Disscussion On Diagnosis And Prognosis Of Acute Respiratory Distress Syndrome By Plasma ADM

Objective: To study the expression level of plasma ADM in ARDS patients with different degree of illness and evaluate the value of ADM in the diagnosis and prognosis of ARDS patients.Methods: Based on Berlin diagnostic and grading criteria(2012),63 patients were enrolled after the screening and were subsequently classified into three groups according to the oxygenation index defined by the Berlin criteria: light,moderate,and severe;and hospitalized patients at the same time.In the control group,20 healthy lung-free lesions(with lung injury score of 0)were selected to observe the outcomes of the 28-day outcome group.The ARDS patients in the case group were assigned to two subgroups: survival and death.Acute physiology and chronic health evaluation II(APACHE II)scores and sequential organ failure assessment(SOFA)scores were included at the time of inclusion.Plasma ADM levels were determined by competitive inhibition ELISA and differences in plasma ADM parameters between groups were analyzed.The correlations between the above indicators and the severity of ARDS patients were analyzed,and the data were processed using SPSS 22.0.The measurement data were analyzed by variance or Mann-Whitney U test.The count data were compared with chi-square test,test was used to compare patients with different prognosis.After the changes in the above-mentioned indicators,the ROC subjects’ working characteristic curves were drawn to evaluate the value of each index for diagnosis.Results:(1)Serum ADM serum markers were significantly higher in the case group than in the non-lung injury group at the same time,and other clinical evaluation indicators were also statistically significant.In the ARDS case group,plasma ADM concentration and APACHE II scores followed.The severity of the disease increased,and paralleled with the severity of the disease.Other indicators including SOFA score,CRP,and PCT were in the ARDS case group.There was no statistically significant difference in the severity of the disease.(2)Plasma ADM was significantly higher in the death group than in the survivor group(P<0.01).ROC curves were plotted for plasma ADM and other clinical parameters in all enrolled patients with ARDS.The plasma ADM was found to have a ROC curve compared to other clinical scoring systems.The lower area(AUC)was higher with an area of 0.95.The plasma ADM had a sensitivity of 91.5% and a specificity of 88% at a cutoff value of 16.8 ug/L.Conclusions:(1)Plasma ADM can be used as a practical serological marker,which has important clinical significance for the diagnosis and assessment of the severity of ARDS patients;(2)The plasma ADM concentration is positively correlated with the severity of ARDS patients;(3)Plasma ADM can be combined with a common clinical score table to jointly assess the patient’s condition and prognosis,and has a reference value for clinical treatment interventions.