脓毒症患者血浆血管生成素2与(1,3)-β-D葡聚糖水平变化及其相关性分析  

Analysis of plasma angiopoietin-2,(1,3)-β-D glucan levels and their correlation in septic patients

作　　者：陈秋萍[1] 冯永民[1] 张媛莉[1] 姚华国[1] 邓烈华[1] 何惠娟[1] 

机构地区：[1]广东医学院附属医院,广东湛江524001

出　　处：《山东医药》2014年第8期21-24,共4页Shandong Medical Journal

基　　金：广东省医学科研基金项目(A2009484);广东省湛江市科技攻关计划项目(2013B01042)

摘　　要：目的观察脓毒症患者血浆血管生成素2(Ang-2)和(1,3)-β-D-葡聚糖(BG)水平变化,并分析二者的关系。方法选择66例脓毒症患者,其中深部真菌感染11例(A组)、二重感染(G-杆菌合并真菌感染)36例(B组)、G-杆菌感染19例(C组),另选20例健康体检者为对照(D组)。24 h内进行急性生理和慢性健康状况(APACHEⅡ)评分、序贯器官衰竭(SOFA)评分,检测血浆Ang-2、BG。结果脓毒症各组血浆Ang-2均高于D组(P均<0.05),而脓毒症各组间血浆Ang-2差异无统计学意义(P均>0.05)。脓毒症各组血浆BG均高于D组(P均<0.05);A、B组血浆BG均高于C组(P均<0.05),而A、B组间差异无统计学意义(P>0.05)。脓毒症患者血浆Ang-2与APACHEⅡ、SOFA评分均呈正相关(r分别为0.599、0.723,P均<0.05),Ang-2与APACHEⅡ、SOFA评分均独立相关(β分别为0.468、0.626,P均<0.05)。除C组外脓毒症患者血浆Ang-2与BG呈正相关(r=0.371,P<0.05);血浆BG与Ang-2独立相关(β=0.393,P<0.05)。结论脓毒症患者血浆Ang-2、BG水平升高,Ang-2是影响脓毒症患者病情严重程度的独立危险因素,BG是影响真菌感染脓毒症患者血浆Ang-2水平的独立危险因素。Objective To investigate the plasma levels of angiopoietin-2 （Ang-2）,（1,3）-β-D-glucan （BG） and their correlation in septic patients.Methods Sixty-six septic patients were divided into three groups：the deep fungal infection group （n =11,group A）,the double infection group caused by fungi and gram-negative bacteria （n =36,group B） and the gram-negative bacteria infection group （n =20,group C）.The healthy volunteers were selected as the control group （n =20,group D）.The acute physiology and chronic health conditions （APACHE） Ⅱ score and sequential organ failure assessment （SOFA） score were recorded within 24 hours.Plasma Ang-2 and BG levels were detected.Results Plasma Ang2 levels were significantly higher in the three septic groups than that in the group D （all P ≤ 0.05）.There were no significant differences in the plasma levels of Ang-2 among these three septic groups （P ＞ 0.05）.Plasma BG levels were all significantly higher in the three septic groups than that of group D （all P ≤ 0.05）.The plasma BG levels in group A and group B were significantly higher than that of group C （P ≤0.05）.There was no significant difference in plasma （1,3）-β-D BG levels between group A and group B （P ＞ 0.05）.The plasma Ang-2 level in septic patients was positively correlated with scores of APACHE Ⅱ and SOFA （r =0.599,P ≤ 0.05 ; r =0.723,P ≤ 0.05,respectively）.The plasma Ang-2 level was independently correlated with the score of APACHE Ⅱ and SOFA in septic patients（β =0.468,P ≤0.05 ;β=0.626,P ≤0.001,respectively）.The plasma Ang-2 level was positively correlated with plasma BG level in septic patients except group C （r =0.371,P ≤ 0.05）.BG level was independently associated with Ang-2 level in septic patients （β =0.393,P≤ 0.05）.Conclusions Plasma Ang-2 and BG levels increase in septic patients.Ang-2 level is an independent risk factor which is associated with the severity of septic patients.BG is an independent risk factor whic

关 键 词：脓毒症 血管生成素2 (1 3)-β-D葡聚糖 急性生理和慢性健康状况评分 序贯器官衰竭评分 

分 类 号：R631[医药卫生—外科学]