全身炎症反应综合征患者血浆E-选择素变化及意义  

Preliminary study of plasma sE-selectin levels in systemic inflammatory response syndrome

作　　者：陈颖[1] 陈雯[1] 许国根[1] 吴锦鸿[1] 陈斓[1] 

机构地区：[1]杭州市第一人民医院急诊科,浙江杭州310006

出　　处：《中国急救医学》2005年第2期89-91,共3页Chinese Journal of Critical Care Medicine

基　　金：杭州市卫生局医药卫生科技计划青年基金项目(No.0202)

摘　　要：目的观察全身炎症反应综合征(SIRS)患者血浆中可溶性E-选择素(sE-selectin)在疾病不同程度分组中的差别及与感染存在的相关性。方法符合SIRS诊断标准的病人60例,入院后做可疑感染分泌物、排泄物等细菌培养,同时肘静脉穿刺取血进行可溶性E-选择素定量测定和APACHE-II评分。根据疾病严重程度分为三组轻度SIRS组、重度SIRS组和休克组。再根据细菌培养结果分为脓毒症组和非脓毒症组。并设对照组。结果轻度SIRS组、重度SIRS组、休克组可溶性E-选择素含量与对照组比较有显著差异(P<0.01);重度SIRS组和休克组可溶性E-选择素含量与轻度SIRS组比较有显著差异(P<0.01);而重度SIRS组和休克组无明显差异(P>0.05)。APACHE-II评分在三组的组间比较中均有显著差异。脓毒症组和非脓毒症组可溶性E-选择素含量比较有显著性差异(P<0.01),两组与对照组比较均有显著差异(P<001)。结论可溶性E-选择素可作为判断SIRS患者疾病的严重程度和预后指标,也可作为区分脓毒症和非脓毒症SIRS的参考指标。Objective To investigate the sE-selectin levels of the plasma in different groups, which were classified based on both the severity and the cause of disease, in order to find out the significance of their changes. Methods 60 patients diagnosed as SIRS were categorized into three groups: mild SIRS, severe SIRS and shock. According to the result of bacteria cultures and symptom, they were also divided into two groups: sepsis and non-sepsis. Twenty healthy age-matched controls were also studied. Blood was drown from elbow vein in each group, in which plasma sE-selectin were detected. Severity of diseases was estimated according to the APACHE-II severity of illness classification system. Results The sE-selectin levels of patients with SIRS in three groups showed obvious differences in contrast to the control group (P<0.01). The sE-selectin levels of severe SIRS group and shock group were significantly higher than those of mild group (P<0.01), but there was no significant difference between severe SIRS group and shock group (P>0.05). There was significant difference in APACHE-II score in related two groups among the three groups (P<0.01). Patients of sepsis showed significantly different from the non-sepsis in sE-selectin (P<0.01), but there was no manifest difference in APACHE-II score between the two groups (P>0.05). Conclusion The sE-selectin level could be a parameter of the disease progress at the early stage of SIRS. sE-selectin could be regarded as a pivotal feature to distinguish sepsis from non-sepsis. [

关 键 词：全身性炎症反应综合征 可溶性E-选择素 脓毒症 

分 类 号：R285[医药卫生—中药学]