血清载脂蛋白M与1-磷酸鞘氨醇在细菌性血流感染中的表达及相关性研究  

Expression and Correlation of Serum Apolipoprotein M and Sphingosine 1-Phosphate in Bacterial Bloodstream Infection

作　　者：张灵玲[1,2] 熊大迁[2] 葛一漫 任然[2] ZHANG Ling-ling;XIONG Da-qian;GE Yi-man;REN Ran(Chengdu University of TCM,Chengdu 611137,China;Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610072,China)

机构地区：[1]成都中医药大学,成都611137 [2]成都中医药大学附属医院,成都610072

出　　处：《现代检验医学杂志》2019年第5期56-58,63,共4页Journal of Modern Laboratory Medicine

基　　金：成都中医药大学科技发展基金(ZRQN1754),成都中医药大学资助

摘　　要：目的通过测定血清载脂蛋白M(ApoM)和1-磷酸鞘氨醇(S1P)在细菌性血流感染及不同感染程度中的表达,发现血清ApoM在细菌感染诊断、治疗及预后中的作用;为ApoM通过载脂蛋白M-1-磷酸鞘氨醇轴(ApoM-S1P)参与细菌感染的炎症反应提供实验室依据。方法收集成都中医药大学附属医院2018年9月~2019年2月细菌感染标本90例,测定血清ApoM和S1P在细菌感染中的表达,探讨血清ApoM与细菌感染的相关性及诊断效能,同时分析血清ApoM和S1P的相关性;根据细菌感染程度进一步分组,分别测定血清ApoM和S1P的表达水平,探讨血清ApoM与感染程度的相关性,并分析血清ApoM和S1P的相关性。结果细菌性血流感染组ApoM和S1P的检测结果分别为11.06±8.02μg/L和119.31±43.7ng/ml,明显低于对照组(25.43±7.05μg/L和192.97±41.74ng/ml),两组间差异有统计学意义(t=-4.716,5.045,均P<0.05),细菌性血流感染组的ApoM和S1P呈线性相关(r=0.774,P=0.00);随着感染程度的加重,ApoM和S1P的表达逐渐下调,在败血症、脓毒血症、严重脓毒血症和脓毒血症休克组中分别为18.08±1.58,11.63±4.85,9.32±6.58和7.95±2.7 μg/L,149.39±10.44,120.67±26.71,111.76±54.94和101.90±32.82 ng/ml,各组间差异均具有统计学意义(F=14.005,6.115,均P<0.05),S1P的表达与ApoM呈线形相关(各组pearson相关系数r=0.569,0.725,0.856和0.873,均P<0.05)。结论ApoM在血液细菌感染早期辅助诊断具有较高的诊断价值;ApoM可能通过ApoM-S1P轴并激活下游受体参与细菌感染的炎症反应,起着潜在的抗炎作用。Objective To find the role of serum ApoM in diagnosis,treatment and prognosis of bacterial infection and provide a laboratory basis for ApoM to participate in the inflammatory reaction of bacterial infection through apolipoprotein M-1-sphingosine axis(ApoM-S1 P),by measuring the ApoM and S1 P in bacterial infection and different infection degree.Methods Collected 90 specimens of bacterial infection in Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from 2018.9~2019.2,determined the expression of ApoM and S1 P in serum ApoM-S1 P in bacterial infection,then investigated the correlation and diagnostic efficacy of serum ApoM and bacterial infection,and analyzed the correlation between serum ApoM and S1 P.Measured the expression of ApoM and S1 P in serum ApoM-S1 P according to the degree of bacterial infection,investigate the correlation between serum ApoM and the degree of infection and analyzed the correlation between serum ApoM and S1 P.Results The expression of ApoMand S1 Pin the bacterial infection group(11.06±8.02μg/L,119.31±43.7 ng/ml)were significantly lower than that in the control group(25.43±7.05μg/L,192.97±41.74 ng/ml),the difference were statistically significant(t=-4.716,5.045,P<0.05).The ApoM were linearly related with S1 P in the bacterial bloodstream infection group(r=0.774,P=0.00).With the aggravation of infection,the expression of ApoM and S1 P were down regulated,the expression in septicemia,sepsis,severe sepsis and sepsis shock were(18.08±1.58,11.63±4.85,9.32±6.58 and 7.95±2.7 ng/ml,149.39±10.44,120.67±26.71,111.76±54.94 and 101.90±32.82 ng/ml),respectively,and the difference were statistically significant among all groups(F=14.005,6.115,P<0.05).The S1 P was linearly related with ApoM in each group,and the correlation coefficient were 0.569,0.725,0.856 and 0.873 respectively(P<0.05).Conclusion ApoM has high diagnostic value in the early diagnosis of blood bacterial infection.ApoM may play a potentialanti-inflammatory role through the apolipoprotein M-1-sphin

关 键 词：载脂蛋白M 1-磷酸鞘氨醇 细菌性血流感染 

分 类 号：R515.3[医药卫生—内科学] R446.112[医药卫生—临床医学]