EPC、FMD与脓毒症患者病情严重程度的相关性研究  

Correlation analysis between EPC, FMD and SOFA in sepsis patients

作　　者：陈伟栋[1] 徐嘉[1] 黄振华[1] 古钎林 廖瑾莉[1] 韦秋霞 詹红[1] Chen Weidong;Xu Jia;Huang Zhenhua;Gu Qianlin;Liao Jinli;Wei Qiuxia;Zhan Hong(Department of Emergency,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院急诊科

出　　处：《新医学》2019年第5期361-365,共5页Journal of New Medicine

基　　金：国家自然科学基金青年项目(81801948);广东省自然科学基金(2016A030313249);广州市科技项目(201804010007)

摘　　要：目的探讨脓毒症患者外周血循环内皮祖细胞(EPC)数量及肱动脉内皮依赖性舒张功能(FMD)与病情严重程度的相关性。方法纳入脓毒症患者15例为脓毒症组,同期住院非脓毒症患者15例为非脓毒症组,以Ficoll密度梯度离心法分离外周血单个核细胞,体外诱导分化EPC,利用ac-LDL及Lectin抗体荧光标记法进行双阳性计数;用彩色多普勒超声检查测定2组患者的FMD;以序贯器官功能衰竭估计(SOFA)评分评价患者病情严重程度。结果脓毒症组患者EPC数量较非脓毒症组少(33.9±7.7vs.45.0±7.4,P<0.05),FMD测定值较低[(6.3±1.2)%vs.(7.7±0.9)%,P<0.05]。EPC数量与FMD测定值呈正相关(rs=0.770,P<0.001);脓毒症组患者EPC数量与SOFA评分呈负相关(rs=-0.615,P<0.001),FMD测定值与SOFA评分呈负相关(rs=-0.636,P=0.011)。结论脓毒症患者外周血循环EPC数量及FMD测定值或可作为评估脓毒症病情严重程度的指标。Objective To investigate the correlation of the number of circulating endothelial progenitor cells(EPCs),brachial artery flow-mediated dilation(FMD)and the severity of sepsis.Methods The clinical data and peripheral blood samples were collected from 15 patients with sepsis and 15 hospitalized patients without sepsis.Peripheral blood mononuclear cells were isolated by Ficoll density gradient centrifugation and were induced to differentiate into EPCs in vitro.The acetylated-LDL(ac-LDL)and lectin-fluorescent staining were performed to evaluate the number of EPCs.Color Doppler ultrasound was conducted to measure the FMD in two groups.Sequential organ failure assessment Score was utilized to evaluate the severity of sepsis.Results Compared with the control group,the number of EPCs was significantly less(33.9±7.7 vs.45.0±7.4,P<0.05),the FMD was also remarkably decreased in the sepsis group,(6.3±1.2)% vs.(7.7±0.9)%(P<0.05).The number of EPCs was positively correlated with the FMD(rs = 0.770,P<0.001).In the sepsis group,the number of EPCs was negatively correlated with SOFA score(rs =-0.615,P<0.001),and FMD was negatively associated with the SOFA score(rs =-0.636,P = 0.011).Conclusion The number of EPCs and FMD might be utilized to evaluate the severity of the sepsis.

关 键 词：脓毒症 内皮祖细胞 肱动脉内皮依赖性舒张功能 序贯器官功能衰竭估计评分 

分 类 号：R459.7[医药卫生—急诊医学]