Objective: To study the clinical application of serum HMGB1 and soluble urokinase plasminogen activator receptor (suPAR) expression in sepsis with acute respiratory distress syndrome (ARDS). Methods: Clinical data of 303 septic patients with/without ARDS were documented. Levels of serum inflammatory markers and HMGB1/suPAR were measured. ARDS patients were subdivided into high and low HMGB1/suPAR expression groups and followed up. Results: Serum HMGB1 and suPAR were upregulated in ARDS patients and positively correlated with inflammatory markers. The combination of HMGB1 with suPAR surpassed HMGB1 or suPAR alone in aiding diagnosis of sepsis with ARDS. CRP, PCT, IL-6, HMGB1 and suPAR were independent risk factors for ARDS. High HMGB1/suPAR expression might be linked to poor prognosis. Conclusion: Serum HMGB1/suPAR levels might aid diagnosis and predict poor prognosis of septic patients with ARDS.
Keywords: HMGB1; diagnosis; independent risk factors; prognosis; receiver operating characteristic; sepsis complicated with acute respiratory distress syndrome; suPAR.
The incidence and mortality rates of acute respiratory distress syndrome (ARDS) attributed to sepsis are considerably high. Early prediction of the occurrence of ARDS is of great significance for clinical treatment and guidance evaluation. This study showed that HMGB1 and soluble urokinase plasminogen activator receptor (suPAR) were highly expressed in the serum of septic patients with ARDS, and that the inflammatory reaction of septic patients with high expression levels of HMGB1 or suPAR was more serious, meaning that sepsis was more likely to cause ARDS. Concurrent measurement of HMGB1 and suPAR was more effective than measurement of HMGB1 or suPAR alone. This study demonstrated that high expression levels of serum HMGB1 and suPAR may increase the risk of poor prognosis (such as death) in septic patients with ARDS. In conclusion, this study measured the expression levels of serum HMGB1 and suPAR, thus providing a theoretical reference for the clinical diagnosis and prognosis of patients with ARDS attributed to sepsis.