The value of α7 nicotinic acetylcholine receptor mRNA,acetylcholine and cholinesterase in early disease assessment and prediction of multiple organ dysfunction syndrome in patients with acute respiratory distress syndrome
Yang Xiaolei
Yang Yi
Abstract：Objective To explore the value of α7 nicotinic acetylcholine receptor(α7nAchR)mRNA,acetylcholine and cholinesterase in early disease assessment and prediction of multiple organ dysfunction syndrome(MODS)in patients with acute respiratory distress syndrome(ARDS).Methods Prospective observational study was adopted.Totally of 65 ARDS patients who needed ventilators admitted to the Intensive Care Unit,Chongqing General Hospital from August 2020 to October 2022 were selected.Within 24 h after confirmation of ARDS,the levels of α7nAchR mRNA in peripheral blood mononuclear cells,peripheral blood acetylcholine and cholinesterase were detected,and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)and MODS scores related to the severity of the patient's disease were conducted.During the 28 d treatment period,the occurrence of MODS was observed and then divided into MODS group(31 cases)and non MODS group(34 cases).The above clinical data were compared between the two groups.The correlation between α7nAchR mRNA,acetylcholine,cholinesterase and APACHE Ⅱ,MODS scores were analyzed.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of α7nAchR mRNA,acetylcholine,and cholinesterase in the occurrence of MODS in patients with ARDS.Results The levels of α7nAchR mRNA,acetylcholine,and cholinesterase in MODS group were significantly lower than those in non MODS group[0.23(0.12,0.32)vs 0.69(0.58,0.87),(201±79)mg/L vs(317±80)mg/L,2 319(1 893,4 241)U/L vs 4 788(3 831,5 379)U/L](all P＜0.001).The levels ofα7nAchR mRNA,acetylcholine and cholinesterase were negatively correlated with APACHE 11 and MODS scores(APACHE Ⅱ score:r=-0.789,-0.650,-0.635,all P＜0.001;MODS score:r=-0.832,-0.658,-0.674,all P＜0.001).The areas under the ROC curve,sensitivities,and specificities of α7nAchR mRNA,acetylcholine and cholinesterase for predicting MODS in ARDS patients were 0.964,100.0％,83.9％;0.848,88.2％,77.4％;0.845,100.0％,58.1％,respectively.α7nAchR mRNA and acetylcholine have higher predictive value.Conclusion The α7nAchR mRNA,acetylcholine,and cholinesterase can reflect the condition of ARDS patients at an early stage and predict the occurrence of MODS,of which α7nAchR mRNA and acetylcholine have a high predictive value.
Keywords：Acute respiratory distress syndromeα7 nicotinic acetylcholine receptorAcetylcholineCholinesteraseMultiple organ dysfunction syndrome
Publication Date：2024-03-08
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 361-365 )