To investigate the value of plasma monocyte chemoattractant protein-1 (MCP-1), soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and high mobility group box 1 (HMGB1) levels in evaluating the condition and prognosis of patients with acute lung injury (ALI).

A total of 120 patients with ALI admitted to the Third People's Hospital of Haikou City from January 2016 to December 2019 were divided into a survival group (n=78) and a death group (n=42) according to their survival status. The age, gender, body mass index, underlying disease, heart rate, respiratory rate, positive end-expiratory pressure, acute physiology and chronic health evaluation (APACHE) Ⅱ score, plasma MCP-1, sTREM-1 and HMGB1 were recorded for all patients. Multivariate Logistic regression was used to analyze independent risk factors affecting the prognosis of patients with ALI. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of plasma MCP-1, sTREM-1 and HMGB1 levels on their prognosis, and the area under the curve (AUC) was compared by the Z test. Pearson correlation was used to investigate the correlation between the plasma MCP-1, sTREM-1, HMGB1 and APACHE Ⅱ score in patients with ALI.

The levels of end-expiratory positive pressure [(14.2 ± 3.7) cmH₂O vs. (9.4 ± 2.9) cmH₂O], APACHE Ⅱ score [(27 ± 6) vs. (14 ± 4)], plasma MCP-1 [(41 ± 7) ng/L vs. (28 ± 5) ng/L], sTREM-1 [(73 ±11) ng/L vs. (49 ± 6) ng/L] and HMGB1 [(43 ± 12) μg/L vs. (18 ± 5) μg/L] in the death group were significantly higher than those in the survival group (t=7.226, 9.813, 10.252, 13.805, 12.724; all P < 0.001). Multivariate Logistic regression analysis showed that the APACHE Ⅱ score [odds ratio (OR)=2.973, 95% confidence interval (CI) (2.120, 6.215), P=0.013], MCP-1 [OR=2.216, 95%CI (1.552, 4.517), P < 0.001], sTREM-1 [OR=2.550, 95%CI (1.713, 5.106), P < 0.001] and HMGB1 [OR=1.894, 95%CI (1.172, 3.195), P < 0.001] were independent risk factors for the prognosis of patients with ALI. ROC curve analysis showed that the APACHE Ⅱ score [AUC=0.770, 95%CI (0.712, 0.834), P=0.012], MCP-1 [AUC=0.812, 95%CI (0.756, 0.873), P < 0.001], sTREM-1 [AUC=0.840, 95%CI (0.781, 0.902), P < 0.001], HMGB1 [AUC=0.793, 95%CI (0.734, 0.851), P=0.005] and the four combinations [AUC=0.926, 95%CI (0.870, 0.988), P < 0.001] all had predictive value for their prognosis, and the AUC of the four combinations was significantly higher than the single APACHE Ⅱ score (Z=5.938, P < 0.001), MCP-1 (Z=5.310, P=0.006), sTREM-1 (Z=4.783, P=0.013) and HMGB1 (Z=5.672, P < 0.001). Pearson correlation analysis showed that the plasma MCP-1, sTREM-1 and HMGB1 levels were positively correlated with APACHE Ⅱ scores in patients with ALI (r=0.783, 0.824, 0.750; all P < 0.001).

The MCP-1, sTREM-1 and HMGB1 levels are correlated with the severity and prognosis of patients with ALI, and their combinations with the APACHE Ⅱ score have good value in predicting the prognosis.