颗粒体上皮蛋白前体在脓毒血症中的变化及其与疾病严重程度的关系  

Changes in serum progranulin concentrations in sepsis and its correlation with the severity of the disease

作　　者：储珍玉[1] 侯淼[2] 黄芳[1] 王俊[1] 郝艳[1] 黄坚[1] 金钧[1] CHU Zhen-yu;HOU Miao;HUANG Fang;WANG Jun;HAO Yan;HUANG Jian;JIN Jun(Department of Critical Care Medicine,the First Affiliated Hospital of Suzhou University,Suzhou 215000,Jiangsu,China)

机构地区：[1]苏州大学附属第一医院重症医学科,江苏苏州215000 [2]苏州大学附属儿童医院心血管内科,江苏苏州215025

出　　处：《广东医学》2019年第20期2890-2893,共4页Guangdong Medical Journal

摘　　要：目的探讨血清颗粒体上皮蛋白前体(progranulin,PGRN)在脓毒血症中的变化及其与炎症反应和疾病严重程度的关系。方法选择急诊重症监护病房(ICU)确诊脓毒血症的41例患者为研究对象,并以20例健康志愿者作为对照组。采用酶联免疫吸附试验(ELISA)法分别检测入ICU当天、治疗3及7 d血清PGRN浓度,并测定炎症指标降钙素原(PCT)、C反应蛋白(CRP)和肿瘤坏死因子-α(TNF-α)水平,并记录入院时急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)、序贯器官衰竭评分(SOFA),以及住院时间和机械通气时间,并分析血清PGRN水平与上述指标的相关性。结果脓毒症患者收入ICU当天血清PGRN浓度较对照组显著下降(P<0.05),入院治疗3 d及7 d后,血清PGRN浓度与入ICU当天相比较逐步上升(P<0.05)。入ICU时血清PGRN浓度与炎症因子PCT(r=-0.615,P<0.05)、CRP(r=-0.635,P<0.01)、TNF-α(r=-0.600,P<0.05)浓度均负相关,且与APACHEⅡ(r=-0.663,P<0.01)、SOFA评分(r=-0.590,P<0.05)呈显著负相关。结论脓毒症患者血清PGRN浓度较正常人明显降低,且与炎症水平及脓毒症严重程度有关,提示PGRN可能作为一种保护性蛋白在脓毒血症发病过程中发挥保护作用,因此,监测脓毒血症患者血清PGRN变化趋势对判断脓毒血症炎症程度和预后一定的临床意义。Objective To investigate the changes of serum progranulin(PGRN)in sepsis patients,and its correlation with infection and prognosis.Methods Forty-one patients with sepsis in intensive care unit(ICU)from June to December in 2017 were enrolled in the current study,and 20 healthy volunteers were enrolled as controls.The serum PGRN were determined by ELISA on the day admitting to ICU,and 3 days and 7 days after ICU admission.And liver function,kidney function and inflammation indicators were accessed.The acute physiology and chronic health evaluation II(APACHE II)and sequential organ failure assessment(SOFA)scores were recorded.Results Serum PGRN in sepsis patients on the day of ICU admission was significantly lower than the control group.Serum PGRN concentrations on the Day 3 and 7 were significantly increased compared with the that on day of ICU admission.Serum PGRN level on the day of ICU admission was negatively correlated with PCT,CRP and TNFαlevels in sepsis patients.Moreover,serum PGRN was negatively correlated with APACHE II and SOFA scores in sepsis patients.Conclusion Serum PGRN decreases in septic patients,and negatively correlates with inflammatory and severity indicators,which suggests clinical indicator in judging the degree of inflammation and prognosis of sepsis.

关 键 词：颗粒体上皮蛋白前体 脓毒血症 炎症 预后 

分 类 号：R459.7[医药卫生—急诊医学] R446.112[医药卫生—治疗学]