ObjectiveTo detect the concentration of 8-isoprostane (8-iso-PG) in exhaled breath condensate (EBC) of patients with or at risk for ARDS in ventilation, and investigate its clinical significance.MethodsFifty-five patients with or at risk for ARDS in ventilation admitted between February 2014 and June 2016 were recruited as an experimental group, and simultaneous 30 normal cases were recruited as a control group. Their EBC was collected with EcoScreen condenser. The EBC 8-iso-PG level of the patients between different grades of ARDS (mild, moderate, and sever) or at risk for ARDS was compared, and the correlation of EBC 8-iso-PG with the clinical indicators was analyzed.ResultsThe 8-iso-PG levels in EBC and serum of the patients with or at risk for ARDS in ventilation were higher than those in the control group [EBC: (44.83±11.58) ng/L vs. (19.47±4.06) ng/L; serum: (481.53±444.94) ng/L vs. (19.91±17.60) ng/L] (all P<0.05). The EBC 8-iso-PG of the patients with moderate ARDS (n=15) and severe ARDS (n=7) [(47.18±11.68) ng/L and (50.29±11.06) ng/L] was higher than those with mild ARDS (n=7) or at risk for ARDS (n=26) [(33.04±7.62) ng/L) and (37.17±11.08) ng/L] (all P<0.05). However EBC 8-iso-PG was not different between the patients with mild ARDS and those at risk for ARDS (P>0.05 ). The increased EBC 8-iso-PG could predict ARDS with an area under the receiver operating curve of 0.73. The EBC 8-iso-PG of the patients with or at risk for ARDS was correlated with lung injury score (r=0.418, P<0.01), PaO2/FiO2 (r=–0.378, P<0.05), chest radiograph scores (r=0.410, P<0.05), AaDO2 (r=0.368, P<0.05), and APACHEⅡ score (r=0.718, P<0.05).ConclusionEBC 8-iso-PG can reflect the oxidative stress in lung of ARDS patients in ventilation, and can contribute to the diagnosis and evaluation for moderate and severe ARDS.
Citation：
ZHANG Wenbin, ZHOU Shujun, WANG Gui, JIN Zhaoquan, ZHU Minghui. Exhaled breath condensate 8-isoprostane of patients with or at risk for ARDS in ventilation. Chinese Journal of Respiratory and Critical Care Medicine, 2018, 17(1): 66-70. doi: 10.7507/1671-6205.201708042
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Copyright © the editorial department of Chinese Journal of Respiratory and Critical Care Medicine of West China Medical Publisher. All rights reserved
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Vaschetto R, Corradi M, Goldoni M, et al. Sampling and analyzing alveolar exhaled breath condensate in mechanically ventilated patients: a feasibility study. J Breath Res, 2015, 9(4): 047106.
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张文彬, 陈建荣. 机械通气患者呼出气冷凝液收集的临床安全性和可行性. 国际呼吸杂志, 2012, 32: 362-366.
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Montuschi P, Ragazzoni E, Valente S, et al. Validation of 8-isoprostane and prostaglandin E(2) measurements in exhaled breath condensate. Inflamm Res, 2003, 52(12): 50-507.
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Tacconelli S, Capone ML, Patrignani P. Measurement of 8-iso-prostaglandin F2alpha in biological fluids as a measure of lipid peroxidation. Methods Mol Biol, 2010, 644(2): 165-178.
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蒋云书, 陈建荣, 张文彬, 等. 急性肺损伤/急性呼吸窘迫综合征患者呼出气冷凝液中血管内皮生长因子 A 检测的临床意义. 中国呼吸与危重监护杂志, 2011, 10 :135-138.
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Ranieri VM, Rubenfeld GD, Thompson BT, et al. Acute respiratory distress syndrome (ARDS): The Berlin Definition. JAMA, 2012, 307: 2526-2533.
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张文彬, 陈建荣, 蔡映云. 改装 EcoScreen 冷凝器收集机械通气患者呼出气冷凝液的研究. 中国呼吸与危重监护杂志, 2010, 9(4): 391-395.
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Murray JF, Matthay MA, Luce JM, et al. An expanded definition of the adult respiratory distress syndrome. Am Rev Respir Dis, 1988, 138(3): 720-723.
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Yin H, Havrilla CM, Gao L, et al. Mechanisms for the formation of isoprostane endoperoxides from arachidonic acid. J Biol Chem, 2003, 278(19): 16720-16725.
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Carpenter CT, Price PV, Christman BW. Exhaled breath condensate isoprostanes are elevated in patients with acute lung injury or ARDS. Chest, 1998, 114(6): 1653-1659.
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李俊英. COX-2 在急性肺损伤中的作用. 中华急诊医学杂志, 2009, 18(12): 1341-1342.
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- 1. Vaschetto R, Corradi M, Goldoni M, et al. Sampling and analyzing alveolar exhaled breath condensate in mechanically ventilated patients: a feasibility study. J Breath Res, 2015, 9(4): 047106.
- 2. 张文彬, 陈建荣. 机械通气患者呼出气冷凝液收集的临床安全性和可行性. 国际呼吸杂志, 2012, 32: 362-366.
- 3. Montuschi P, Ragazzoni E, Valente S, et al. Validation of 8-isoprostane and prostaglandin E(2) measurements in exhaled breath condensate. Inflamm Res, 2003, 52(12): 50-507.
- 4. Tacconelli S, Capone ML, Patrignani P. Measurement of 8-iso-prostaglandin F2alpha in biological fluids as a measure of lipid peroxidation. Methods Mol Biol, 2010, 644(2): 165-178.
- 5. 蒋云书, 陈建荣, 张文彬, 等. 急性肺损伤/急性呼吸窘迫综合征患者呼出气冷凝液中血管内皮生长因子 A 检测的临床意义. 中国呼吸与危重监护杂志, 2011, 10 :135-138.
- 6. Ranieri VM, Rubenfeld GD, Thompson BT, et al. Acute respiratory distress syndrome (ARDS): The Berlin Definition. JAMA, 2012, 307: 2526-2533.
- 7. 张文彬, 陈建荣, 蔡映云. 改装 EcoScreen 冷凝器收集机械通气患者呼出气冷凝液的研究. 中国呼吸与危重监护杂志, 2010, 9(4): 391-395.
- 8. Murray JF, Matthay MA, Luce JM, et al. An expanded definition of the adult respiratory distress syndrome. Am Rev Respir Dis, 1988, 138(3): 720-723.
- 9. Yin H, Havrilla CM, Gao L, et al. Mechanisms for the formation of isoprostane endoperoxides from arachidonic acid. J Biol Chem, 2003, 278(19): 16720-16725.
- 10. Carpenter CT, Price PV, Christman BW. Exhaled breath condensate isoprostanes are elevated in patients with acute lung injury or ARDS. Chest, 1998, 114(6): 1653-1659.
- 11. 李俊英. COX-2 在急性肺损伤中的作用. 中华急诊医学杂志, 2009, 18(12): 1341-1342.
