比较骨桥蛋白与降钙素原在肠源性脓毒症大鼠中的诊断价值  

Objective to compare the diagnostic value of osteopontin and procalcitonin in rats with intestinal sepsis

作　　者：王蕾 张培荣[2] 张明[2] 迟晓明[2] 盛楠[1] 张勇[1] 

机构地区：[1]潍坊医学院山东潍坊,2610532 [2]潍坊医学院附属医院重症医学科

出　　处：《临床急诊杂志》2017年第10期758-762,共5页Journal of Clinical Emergency

摘　　要：目的:研究骨桥蛋白和降钙素原在肠源性脓毒症大鼠血清中的表达、与脓毒症严重程度的相关性以及关于肠源性脓毒症诊断价值的比较。方法:将120只SD大鼠按随机数字表分肠源性脓毒症组50只,SIRS组50只,空白对照组20只,脓毒症组和SIRS组再按术后1、3、6、12、24h分为5组,每组10只。肠源性脓毒症组采用盲肠结扎穿孔法复制脓毒症,SIRS组腹部探查取出盲肠后还纳腹腔。肠源性脓毒症组和SIRS组造模后1、3、6、12、24h观察大鼠一般情况,并通过心脏采集1ml血液,然后处死,取肺组织。酶联免疫吸附实验(ELISA)测定大鼠血浆骨桥蛋白、PCT水平。结果:肠源性脓毒症组大鼠血清骨桥蛋白水平在术后1、3、6、12、24h相互比较,差异均具有统计学意义(P<0.01),血清PCT水平在术后1、3、6、24h比较差异具有统计学意义(P<0.01),术后6h与12h比较,差异不具有统计学意义;肠源性脓毒症组、SIRS组、空白对照组的血清骨桥蛋白与PCT水平差异具有统计学意义(P<0.01),且在肠源性脓毒症组血清骨桥蛋白水平较于PCT升高更明显;相关分析发现肠源性脓毒症与骨桥蛋白水平呈正相关(r=0.90,P<0.01);肠源性脓毒症与降钙素原水平呈正相关(r=0.85,P<0.01);骨桥蛋白ROC曲线下面积为0.82±0.06,诊断脓毒症的临界值为0.46,此时的敏感度为76.7%,特异度为94.2%。PCT诊断脓毒症的曲线下面积为0.86±0.05,诊断脓毒症的临界值为0.21,此时的敏感度为66.7%,特异度为93%。结论:血清骨桥蛋白较PCT在肠源性脓毒症大鼠的诊断中更具诊断价值。Objective：To investigate the expression of osteopontin and procalcitonin in the serum of rats with intestinal sepsis and the correlation with the severity of sepsis and to compare the diagnostic value of intestinal sepsis. Method：One hundred and twenty SD rats were randomly divided into： intestinal sepsis group （50）, SIRS group （50）, and blank control group （20）. And sepsis group and SIRS group were then divided into five groups according to postoperative time l h, 3h, 6h, 12h, 24h （10 rats in each group）. In the intestinal sepsis group, the rats with sep- sis were induced by cecal ligation and puncture. In the SIRS group,the abdominal cavity was closed after cecal ex- ploration operation. After 1,3,6,12 and 24 hours,the general situation of the rats in the group of intestinal sepsis and the SIRS group were observed, and the blood was collected by heart. Then the rats were killed and the lung tis- sues were taken out. The levels of osteopontin and PCT in rat plasma were measured by enzyme linked immunosorbent assay （ELISA）. Result： Osteopontin levels in rats serum of enterogenous sepsis group after 1 h, 3h, 6h, 12h and 24h are compared,the differences were statistically significant （P〈0.01）, serum PCT levels in postoperative 1 H, 3h, 6h, 24h with statistical significance of difference （P〈0.01 ）, postoperative 6h and 12h are compared, the difference was not statistically significant （P ~ 0.05） ; There was statistically significant difference of serum osteopon tin and PCT level among enterogenous sepsis group,SIRS group and control group （P〈0.01） ,and in the enterogenous sepsis group,serum osteopontin levels increased more significantly than PCT; Correlation analysis showed that there was a positive correlation between intestinal sepsis and osteopontin level （r= 0.90 ,P〈0.01） ,and positive correlation between intestinal sepsis and osteopontin （r= 0. 85, P〈0.01）; The area under the osteopontin ROC curve was 0. 82 - 0. 06. The critical value of the diagnos

关 键 词：肠源性脓毒症 骨桥蛋白 PCT 

分 类 号：R826.3[医药卫生—临床医学]