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目的 探讨S100A12蛋白水平在急性呼吸窘迫综合征(ARDS)患者外周血中的表达及临床意义.方法 纳入潍坊医学院附属医院、潍坊市人民医院2015年10月至2016年12月收治的ARDS患者,根据患者氧合状态选取轻度组(n=20)、中度组(n=20)和重度组(n=20),共60例纳入研究.随访患者30 d预后情况,分为生存组(n=37)和死亡组(n=23).选取同期60例健康体检者作为对照组.收集所有研究对象临床基本资料.采集所有研究对象清晨空腹静脉血4 ml,采用ELISA方法检测血清中S100A12的表达.结果 与对照组比较,ARDS患者血清中S100A12、白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)水平以及急性生理学和慢性健康状况评分系统Ⅱ(APACHE Ⅱ)评分显著升高,PaO2/FiO2明显降低,差异有统计学意义(均P＜0.05).S100A12水平与ARDS严重程度呈正相关,重度组患者血清中S100A12水平高于中度组,中度组高于轻度组,差异有统计学意义(均P＜0.05).ARDS患者血清中S100A12水平与IL-1、TNF-α、APACHEⅡ评分呈正相关(P＜0.05),而与PaO2/FiO2呈负相关(P＜0.05).对死亡组有关影响因素进行Logistic回归分析显示IL-1、TNF-α、APACHEⅡ评分、S100A12是ARDS患者死亡的独立危险因素,PaO2/FiO2则是ARDS患者死亡的独立保护因素.ARDS患者血清中S100A12蛋白水平在预后评估时的ROC曲线下面积表明S100A12蛋白水平对ARDS的转归有一定的预测价值,可作为预后评估的辅助性指标.结论 ARDS患者血清中S100A12水平显著升高,与病情严重程度密切相关,对ARDS早期诊断、治疗及预后有着一定的临床应用价值.“,”Objective To investigate the expression of S 100A 12 protein in peripheral blood of patients with acute respiratory distress syndrome (ARDS) and its clinical significance.Methods Sixty ARDS patients admitted between October 2015 and December 2016 were included in the study.They were divided into a mild group (n=20),a moderate group (n=20) and a severe group (n=20) according to the oxygenation state.Meanwhile they were divided into a survival group (n=37) and a death group (n=23) according to the 30-day prognosis.Sixty simultaneous healthy subjects were selected as a control group.The clinical data of all subjects were collected.Fasting venous blood was collected in the morning for measurement of S100A12 expression in peripheral blood by ELISA method.Results Compared with the control group,the levels of S 100A 12,interleukin-1 (IL-1),tumor necrosis factor alpha (TNF-a) in peripheral blood and APACHE Ⅱ score were significantly increased in the ARDS patients,and PaO2/FiO2 was significantly decreased (all P＜0.05).The level of S100A12 in peripheral blood was positively correlated with the severity of ARDS.The level of S100A12 was much higher in the severe group than that in the moderate group and the mild group,and higher in the moderate group than that in the mild group (all P＜0.05).Correlation analysis showed that S100A12 level in peripheral blood of the ARDS patients was positively correlated with IL-1,TNF-α and APACHE Ⅱ score (P＜0.05),but negatively correlated with PaO2/FiO2 (P＜0.05).Logistic regression analysis showed that IL-1,TNF-α,APACHE Ⅱ score and S100A12 were independent risk factors for prognosis of ARDS.PaO2/FiO2 was an independent protective factor for prognosis of ARDS.ROC curve analysis showed that the S 100A12 level had a certain predictive value for ARDS and could be used as a prognostic indicator.Conclusions The level of S100A 12 in peripheral blood of ARDS patients is significantly increased and is closely related to the severity of ARDS.It has a potential clinical value for early diagnosis,treatment and prognosis of ARDS.