血型与ards.ppt

严重创伤及脓毒血症后严重创伤及脓毒血症后ARDSARDS风险风险或与血型相关或与血型相关 严重创伤及脓毒血症后严重创伤及脓毒血症后ARDSARDS风险或与风险或与血型相关血型相关 ABO blood type A is associated with increased risk of ARDS in whites following both major trauma and severe sepsis.ABO glycosyltransferases catalyze antigen modifications on various glycans and glycoproteins and determine the ABO blood types.ABO糖基转移酶能促进各种多聚糖和糖蛋白抗原的改变，并决定人们的ABO血型。Blood type A has been associated with increased risk of vascular diseases and differential circulating levels of proteins related to inflammation and endothelial function.The objective of this study was to determine the association of ABO blood types with ARDS risk in patients with major trauma and severe sepsis 已知A型血与血管性疾病风险增加、循环中炎症以及内皮功能相关蛋白质水平的差异有关。但其与严重创伤和脓毒症患者的急性呼吸窘迫综合征（ARDS）之间是否也存在某种关系目前还不清楚。We conducted prospective cohort studies in two populations at an urban tertiary referral,level I trauma center.Critically ill patients(n 5 732)presenting after major trauma were followed for 5 days for ARDS development.Additionally,976 medical patients with severe sepsis were followed for 5 days for ARDS.Multivariable logistic regression was used to adjust for confounders.该项前瞻性队列研究纳入人群包括在一家三级城市的转诊中心和级创伤中心内就诊的2类患者：732例严重外伤后的危重患者及976例患有严重脓毒症的内科患者。研究人员对这些患者分别进行了为期5天的随访，以观察其ARDS的发生状况；并采用多变量logistic回归分析对相关混杂因素进行了校正。ARDS developed in 197 of the 732 trauma patients(27%).Blood type A was associated with increased ARDS risk among whites(37%vs 24%;adjusted OR,1.88;95%CI,1.14-3.12;P 5.014),but not blacks(adjusted OR,0.61;95%CI,0.33-1.13;P=.114).ARDS developed in 222 of the 976 patients with severe sepsis(23%).Blood type A was also associated with an increased ARDS risk among whites(31%vs 21%;adjusted OR,1.67;95%CI,1.08-2.59;P=.021)but,again,not among blacks(adjusted OR,1.17;95%CI,0.59-2.33;P=.652).研究的主要结果为：在732例外伤患者中，有197例（27%）发生了ARDS。其中，A型血与白种人ARDS风险增加显著相关，调整后的风险比值比为1.88，但在非裔美国人中则不存在这种相关性。在976例严重脓毒症患者中，有222例（23%）出现了ARDS。其中，A型血也与白种人ARDS风险的增加相关，调整后比值比为1.67；同样在非裔美国人中也不存在这种相关性。Blood type A is associated with an increased risk of ARDS in white patients with major trauma and severe sepsis.These results suggest a role for ABO glycans and glycosyltransferases in ARDS susceptibility.该研究显示，对于美国白种人而言，A型血与严重创伤及脓毒症患者ARDS风险的增加相关。这表明ABO多聚糖和糖基转移酶对某些患者的ARDS易感性有一定影响。