THE RELATIONSHIP BETWEEN SOLUBLE CD74, SCD14 AND SEVERITY AND PROGNOSIS IN PATIENTS WITH ACUTE RESPIRATORY DISTRESS SYNDROME

Li Yang¹, Qiang Fang^{2, *}

¹Department of Critical Medicine, School of Medicine, Zhejiang University, Hangzhou, PR China - ²Department of Critical Medicine, the First Affiliated Hospital of Zhejiang University Medical College, Hangzhou, PR China

Objective: To investigate the relationship between soluble leukocyte differentiation antigen 74 (sCD74) and soluble leukocyte differentiation antigen 14 (sCD14) and severity and prognosis in patients with acute respiratory distress syndrome (ARDS).

Methods: A total of 96 patients with ARDS were randomly divided into mild, moderate and severe groups according to differences in their oxygenation index (OI): mild group (n=19), moderate group (n = 44) and severe group (n=33). Moreover, 35 healthy subjects were selected as the normal group. The serum sCD74 and sCD14 levels were measured by enzyme-linked immunosorbent assay (ELISA), and the changes in APACHE Ⅱ scores were also compared in each group. According to the outcome of prognosis, patients were divided into either the death group (n=22) or survival group (n=74). Changes in serum sCD74 level, sCD14 level and APACHE Ⅱ score were measured in these two groups. The correlation between serum sCD74 and sCD14 level, as well as ARDS severity, were analysed according to the Pearson correlation test.

Results: Compared to the normal group, the serum sCD74 levels, sCD14 levels and APACHE Ⅱ scores in the study group were significantly higher than those in the normal group (P<0.05). Serum sCD74 level, sCD14 level and APACHE Ⅱ score increased significantly (P<0.05) with the increasing ARDS severity of patients, among which the mild group had the lowest level and the severe group had the highest level. Compared to the survival group, the serum sCD74 levels, sCD14 levels and APACHE Ⅱ scores of the death group were significantly higher than those of the survival group (P<0.05). The areas under the curve of serum sCD74, sCD14 and sCD74/sCD14 in patients with ARDS were 0.823, 0.746 and 0.933, respectively. The combined detection of serum sCD74 and sCD14 was more valuable in evaluating the prognosis of patients with ARDS. The Pearson correlation test indicated a significant positive correlation between serum sCD74 levels, sCD14 levels and APACHE Ⅱ scores in patients with ARDS (r=0.325, P<0.05 and r=0.469, P<0.05, respectively).

Conclusion: The serum levels of sCD74 and sCD14 in patients with ARDS are significantly higher than that in patients with ARDS. Moreover, their levels can exhibit certain values that can be used to judge the severity and prognosis of patients with ARDS.