A study on the value of MMP-9 in early diagnosis and prognostic evaluation of patients with acute respiratory distress syndrome complicated with septic shock

HU Miao; XIANG Shulin; XIONG Bin; HAN Lin; PANG Jing; JIANG Lingyu; JI Debin; WANG Han; HUANG Zhen; REN Yanwen

doi:10.3969/j.issn.1674-3806.2024.02.05

Abstract：Objective To explore the value of matrix metalloproteinase-9(MMP-9)in early diagnosis and prog-nostic evaluation of patients with acute respiratory distress syndrome(ARDS)complicated with septic shock.Methods A total of 113 ARDS patients admitted to the People's Hospital of Guangxi Zhuang Autonomous Region from April 2020 to April 2023 were selected as the study subjects.The patients were divided into ARDS complicated with septic shock group(61 cases)and ARDS non-septic shock group(52 cases)according to the occurrence of shock within 24 hours after they were diagnosed with ARDS.A total of 22 healthy volunteers were selected as the normal control group during the same period.The patients in the ARDS complicated with septic shock group were divided into survival group(27 cases)and death group(34 cases)according to their outcomes 28 days after treatment.The general data and the level of MMP-9 expression in each group were compared.Receiver operating characteristic(ROC)curve was used to evaluate the accu-racy of MMP-9 in the early diagnosis of ARDS complicated with septic shock patients.Logistic regression analysis was used to explore the influencing factors of prognosis of the ARDS complicated with septic shock patients.Results The level of MMP-9 expression in the ARDS complicated with septic shock group and the ARDS non-septic shock group was higher than that in the normal control group,and the level of MMP-9 expression in the ARDS non-septic shock group was higher than that in the ARDS complicated with septic shock group,and the differences were statistically significant(P＜0.05).The results of ROC curve analysis showed that MMP-9 could effectively predict the occurrence of ARDS com-plicated with septic shock[AUC(95％CI)=0.666(0.565-0.767)],and the optimal cut-off value was 28.53 ng/mL,and the corresponding sensitivity and specificity were 47.50％and 94.20％,respectively.The results of multivariate logistic regression analysis showed that MMP-9[OR(95％CI)=0.976(0.954-0.999)],oxygenation index[OR(95％CI)=0.978(0.957-1.000)]and interleukin-6(IL-6)[OR(95％CI)=1.004(1.000-1.008)]were influencing factors for death in the ARDS complicated with septic shock patients(P＜0.05).The results of ROC curve analysis showed that MMP-9 could effectively predict the prognosis of the ARDS complicated with septic shock patients[AUC(95％CI)=0.735(0.605-0.865)],and the optimal cut-off value was 33.83 ng/mL,and the corresponding sensitivity and spe-cificity were 70.59％and 77.78％,respectively.Conclusion MMP-9 has good value in early diagnosis of ARDS com-plicated with septic shock,and has a certain predictive effect on the severity and prognosis of ARDS complicated with septic shock patients.