脓毒症合并弥散性血管内凝血患者血清G-CSF水平及意义  

Levels and value of serum granulocyte colony stimulating factor from severe sepsis patients with disseminated intravascular coagulation

作　　者：胡敦重[1] 宋景春[2] 林兆奋[1] 赵良[1] 

机构地区：[1]解放军第二军医大学附属长征医院急救科,上海200003 [2]解放军第九四医院ICU,江西南昌330002

出　　处：《中国急救医学》2013年第4期306-309,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的检测脓毒症及合并弥散性血管内凝血（DIC）患者血清中粒细胞集落刺激因子（G-CSF）水平，并判断其对脓毒症患者发展成为DIC的诊断意义。方法严重脓毒症患者28例（SS组），脓毒症合并DIC患者12例（SSD组），同期门诊体检者20例为对照组，收集临床及实验室参数，计算APACHEⅡ评分和DIC评分；采用酶联免疫吸附测定（ELISA）方法检测血清G-CSF水平。结果ss组和SSD组患者血G-CSF水平较对照组明显升高（P〈0．05），但SS组和SSD组患者之间血清G-CSF水平差异无统计学意义（P〉0．05）。相关分析显示，G-CSF与WBC、PCT、APACHEⅡ评分呈显著正相关。ROC曲线图显示，血清G-CSF的AUC=0．887，95％CI为（0．825，0964）（P〈0．05）。结论血清G-CSF水平主要与脓毒症严重程度有关，与DIC的发病机制无明显相关性，可作为脓毒症严重程度判断的实验室证据。Objective To examine the levels of serum granulocyte colony stimulating factor from severe sepsis patients with disseminated intravascular coagulation （DIC） so as to evaluate the value for diagnosis for severe sepsis with DIC. Methods Sixty patients were divided into 3 groups, severe sepsis group （SS group, 28 cases）, severe sepsis with DIC group（ SSD group, 12 cases） and normal group（ 20 cases）. Clinical data of these patients were collected, including APACHE Ⅱ score and DIC score. Serum levels of G - CSF were measured in patients by ELISA. Results There are higher levels of G - CSF in patients with SS group and with SSD group than those in healthy control （ P 〈 0.05 ）. The patients of SS group and SSD group had higher levels of G - CSF than did healthy control （ P 〈 0.05 ）. An association was found between G- CSF and WBC（r =0. 832, P =0. 037）, G - CSF and PCT （r =0. 818, P = O. 010） , G - CSF and APACHE Ⅱ score（ r = 0. 806, P = O. 040）. The areas under the curves （AUC） for G - CSF was 0. 887 （95 % CI = 0. 825 - 0. 964, P 〈 0.05 ）. Conclusion Serum levels of G - CSF of patients of severe sepsis increased highly, which maybe benefit diagnosis for severe sepsis.

关 键 词：粒细胞集落刺激因子(G-CSF) 降钙素原(PCT) 白细胞计数(WBC) 

分 类 号：R720.597[医药卫生—急诊医学]