The Role Of Angiotensin-2 And Soluble Receptor For Advanced Glycation End Products In The Pathogenesis Of Septic Associated Acute Respiratory Distress Syndrome

objective:To investigate the role of Ang-2 and sRAGE in the pathogenicity of sepsis related ARDS,and to evaluate whether Ang-2 and sRAGE can play an role in the early diagnosis of sepsis related ARDS.Method:The patients with sepsis related ARDS hospitalized in Shanxi Bethune Hospital from May 2021 to January 2022 were selected as the experimental group,the patients with sepsis as the case control group,and the adults who underwent physical examination in the physical examination center of our hospital during the same period were selected as the healthy control group.The statistical analysis software SPSS25.0was used to compare the expression levels of Ang 2 and sRAGE of subjects in each group,and the correlation between these two indexes and laboratory indexes(white blood cell count,neutrophil count,lymphocyte count,neutrophil to lymphocyte ratio,monocyte count and eosinophil count)was analyzed.Logistic regression was used to analyze the risk factors of sepsis related ARDS,and receiver operation characteristic curve was drawn.ROC curve)to analyze the diagnostic efficacy of Ang-2 and sRAGE in early identification of sepsis related ARDS.Results:There were significant differences in the expression levels of Ang-2 and sRAGE among the three groups(P<0.01,P<0.05,respectively).In addition,compared with case control group(3378.06±912.67,1343.63±334.49)ng/L and healthy control group(2852.48±411.97,1365.53±211.54)ng/L,The expression levels of Ang 2 and sRAGE ng/L(4031.28±815.26,1514.86±344.44)in experimental groups were significantly increased,with statistical significance(all P<0.05).Pearson and Spearman correlation analysis showed that serum Ang-2 and sRAGE levels were correlated with oxygenation index(correlation coefficients r=0.671,r=0.491,respectively).Multivariate Logistic regression analysis showed that Ang-2 and sRAGE were risk factors for sepsis related ARDS(P < 0.05,P < 0.01,respectively).The ROC curve was drawn,and it was found that the high expression of Ang-2 and sRAGE both had certain diagnostic value in the early identification of sepsis related ARDS.However,the diagnostic efficacy of sRAGE(AUC = 0.702,sensitivity = 76.5%,specificity = 45.5%)was inferior to that of Ang-2(AUC = 0.724,sensitivity = 94.1%).The specificity was 48.3%).Conclusion:The expressions of Ang-2 and sRAGE are significantly increased in the patients with sepsis associated ARDS group,and the high expression of Ang-2 and sRAGE is a high risk factor for the development of sepsis associated ARDS.The high expression of Ang-2 and sRAGE both have certain diagnostic value in the early identification of sepsis related ARDS,but the diagnostic efficacy of sRAGE is inferior to that of Ang-2,and the latter is significantly correlated with the severity of the disease in the experimental group.