Relationship between Krebs von den Lungen-6 and acute lung injury in patients with Standford aortic type A dissection

doi:10.3969/j.issn.1673-8640.2023.06.007

Abstract

Abstract:

Objective To investigate the relationship between serum Krebs von den Lungen-6（KL-6） and acute lung injury in Standford aortic type A dissection. Methods A total of 78 patients in Taihe Hospital of Shiyan from May 2019 to May 2021 were diagnosed as Standford aortic type A dissection. According to the oxygenation index during static oxygen inhalation，the patients were classified into lung injury group（30 cases） and non-lung injury group（48 cases）. The clinical data and laboratory determination results of all the patients were collected，and serum KL-6 levels were determined at 12 h before surgery（T1），after induction of anesthesia（T2），after surgery（T3） and 12 h after surgery（T4）. Stepwise Logistic regression analysis was used to assess the risk factors for acute lung injury in Standford aortic type A dissection. Pearson correlation analysis was used to evaluate the correlation among all the indicators. Results Serum KL-6 level of patients in lung injury group was higher than that of non-lung injury group at each time point（P<0.001）. Serum KL-6 levels of the 2 groups at T3 and T4 time points were higher than those at T1 and T2 time points（P<0.05）. For lung injury group and non-lung injury group，the case number of dissection stage （acute stage） and the case number of involving superior mesenteric artery，white blood cell（WBC），high-sensitivity C-reactive protein（hs-CRP） and serum KL-6 levels had statistical significance between lung injury and non-lung injury groups（P<0.05）. Multivariate Logistic regression analysis showed that hs-CRP [odds ratio（OR）=2.063，95% confidence interval（CI） 1.104-3.854] and serum KL-6（OR=2.555，95%CI 1.272-5.133） are independent risk factors for acute lung injury in Standford aortic type A dissection（P<0.05）. Pearson correlation analysis results showed that serum KL-6 and hs-CRP were negatively correlated with oxygenation index（r=-0.561 and -0.368，P<0.01）. Conclusions Serum KL-6 levels are correlated with the occurrence of acute lung injury in Standford aortic type A dissection.

Key words: Krebs von den Lungen-6, Standford aortic type A dissection, Acute lung injury

CLC Number:

R446.1

YUAN Ye, LIU Tao, LIU Hua. Relationship between Krebs von den Lungen-6 and acute lung injury in patients with Standford aortic type A dissection[J]. Laboratory Medicine, 2023, 38(6): 543-547.

Figures/Tables 4

References 20

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组别	例数	性别		年龄/岁	BMI/ （kg/m²）	吸烟史/ 例	高血压史/例	糖尿病史/例	冠心病史/例	脑血管病史/例
组别	例数	男/例	女/例	年龄/岁	BMI/ （kg/m²）	吸烟史/ 例	高血压史/例	糖尿病史/例	冠心病史/例	脑血管病史/例
肺损伤组	30	18	12	46.37±3.24	24.68±1.25	19	27	9	9	5
非肺损伤组	48	27	21	45.12±3.26	24.35±1.28	32	44	13	16	7
统计值		0.106		1.651	1.118	0.091	0.063	0.078	0.094	0.062
P值		0.744		0.103	0.267	0.763	0.802	0.781	0.759	0.804

组别	例数	性别		年龄/岁	BMI/ （kg/m²）	吸烟史/ 例	高血压史/例	糖尿病史/例	冠心病史/例	脑血管病史/例
组别	例数	男/例	女/例	年龄/岁	BMI/ （kg/m²）	吸烟史/ 例	高血压史/例	糖尿病史/例	冠心病史/例	脑血管病史/例
肺损伤组	30	18	12	46.37±3.24	24.68±1.25	19	27	9	9	5
非肺损伤组	48	27	21	45.12±3.26	24.35±1.28	32	44	13	16	7
统计值		0.106		1.651	1.118	0.091	0.063	0.078	0.094	0.062
P值		0.744		0.103	0.267	0.763	0.802	0.781	0.759	0.804

组别	例数	T1/（U/mL）	T2/（U/mL）	T3/（U/mL）	T4/（U/mL）
肺损伤组	30	215.43±22.19	276.85±28.26	336.57±31.42^*#	398.46±37.25^*#
非肺损伤组	48	139.58±21.46	162.51±25.32	195.56±28.43^*#	215.43±31.27^*#
t值		14.990	18.553	20.464	23.352
P值		<0.001	<0.001	<0.001	<0.001

组别	例数	T1/（U/mL）	T2/（U/mL）	T3/（U/mL）	T4/（U/mL）
肺损伤组	30	215.43±22.19	276.85±28.26	336.57±31.42^*#	398.46±37.25^*#
非肺损伤组	48	139.58±21.46	162.51±25.32	195.56±28.43^*#	215.43±31.27^*#
t值		14.990	18.553	20.464	23.352
P值		<0.001	<0.001	<0.001	<0.001

组别	例数	夹层分期		累及情况				胸腔积液		主动脉瓣关闭不全
		急性期/例	慢性期/例	头臂动脉/例	肠系膜上动脉/例	肾动脉		单侧/例	双侧/例	轻度/例	中度/例		重度/例
		急性期/例	慢性期/例	头臂动脉/例	肠系膜上动脉/例	单侧/例	双侧/例	单侧/例	双侧/例	轻度/例	中度/例		重度/例
肺损伤组	30	26	4	18	11	9	7	16	6	2	4		4
非肺损伤组	48	29	19	22	4	13	8	29	11	6	4		3
统计值		6.118		19.738		0.805		1.133		2.197
P值		0.013		<0.001		0.669		0.568		0.533
组别	ST段改变/例	低蛋白血症/例		心脏射血分数	凝血酶原时间/s	WBC计数/（×10⁹/L）		hs-CRP/（mg/L）		KL-6^①/ （U/mL）		血肌酐/（μmol/L）
肺损伤组	14	7		0.53±0.12	13.48±3.56	13.62±3.45		16.25±3.24		387.64±43.15		87.54±26.43
非肺损伤组	18	13		0.57±0.14	14.22±3.17	8.24±1.36		8.39±2.12		217.62±34.29		96.42±23.67
统计值	0.641	0.136		1.295	0.956	9.695		12.965		19.267		1.541
P值	0.423	0.712		0.199	0.342	<0.001		<0.001		<0.001		0.128