中文摘要：

目的：探讨肥胖急性呼吸窘迫综合征（ARDS）患者血清趋化素（chemerin）水平改变与临床预后的相关性。方法：连续性纳入2014-06-2016-11在我院住院治疗的80例肥胖ARDS患者。根据28d死亡事件情况分为死亡组（n=28）和存活组（n=52）。所有患者分别于入组时和入组第3天检测血清chemerin水平,并计算APACHEⅡ和SOFA评分。结果：入组后第3天,死亡组患者chemerin水平明显高于存活组[（35.2±5.7）mg/L vs.（11.5±1.9）mg/L,P〈0.05）]。死亡组△chemerin（第3天chemerin-入组时chemerin）明显高于存活组[（15.6±4.1）mg/L vs.（-0.9±0.2）mg/L,P〈0.05）]。存活组第3天APACHEⅡ评分明显低于死亡组[（18.6±3.9）vs.（27.1±3.3）,P〈0.05）]。通过ROC曲线分析发现,第3天chemerin水平（AUC=0.733）和△chemerin水平（AUC=0.812）对于ARDS患者28d死亡风险有一定的预警价值。相关性分析可见第3天chemerin和△chemerin与28d死亡风险呈正相关（r=0.677、0.623,P〈0.05）。通过Logistic回归分析发现第3天chemerin（OR=2.02,95%CI：1.55~3.78,P〈0.05）和△chemerin（OR=2.33,95%CI：1.76~3.44,P〈0.05）为ARDS患者28d死亡事件发生的独立危险因素。结论：肥胖ARDS患者血清chemerin水平明显升高可以作为28d死亡风险的预警信号。

英文摘要：

Objective.. To evaluate the correlation value between serum chemerin and 28-day mortality in obesity patients with ARDS. Method：From June 2014 to November 2016, eighty ARDS patients were enrolled in this study and divided into survival grouping52） and death grouping28） based on 28-day mortality. The levels of chemer- in,APACHE H and SOFA score were measured on the admission day,T0） and three days later（T1）. Result：On the third day, the contents of ehemerin in death group were higher than those in survival group [（35. 2± 5.7） mg/L vs. （ 11.5 ± 1.9） mg/L, P〈0. 051. The fluctuation of ehemerin ehemerin） in death group were high- er than those in survival group （15.6±4.1） mg/L vs. （0.9±0.2） mg/L,P〈0.05）3. The APACHE 11 score of survival group were lower than that of death group （8. 6±3.9） vs. （27.1±3.3） ,P〈0.05）3. ROC analysis showed that ehemerin of T3 （ AUC= 0. 733）and A ehemerin（AUC= 0. 812）were useful to forecast 28-day mortali- ty. Correlation analysis showed ehemerin of T3and Achemerin were positively related with 28-day mortality（r=0. 677,0. 623,P〈0.05）. Logistic regression analysis reminded that ehemerin of T3（OR=2.02,95%CI： 1.55% 3.78,P〈0.05） and Achemerin（OR=2.33,95%CI： 1.76%3.44,P〈0.05）were independent risk factors of 28- day mortality in patients with ARDS. Conclusion：Increasing levels of ehemerin may be a warning signal for 28-day mortality in obesity patients with ARDS.