脓毒症患者血浆脂氧素A4的表达水平与患者预后的关系  

Relationship between the level of plasma lipoxin A4 and prognosis in patients with sepsis

作　　者：蒋永泼 陈南瑾 俞玉龙 张梦芹 蔡敏杰 张胜[1] 崔可[1] 林荣海[1] JIANG Yong-po;CHEN Nan-jin;YU Yu-long;ZHANG Meng-qin;CAI Min-jie;ZHANG Sheng;CUI Ke;LIN Rong-hai(Department of Critical Care Medicine,Taizhou Hospital of Zhejiang Province,Linhai,Zhejiang 317000,China;不详)

机构地区：[1]浙江省台州医院重症医学科,浙江临海317000 [2]浙江省台州医院麻醉科,浙江临海317000

出　　处：《中华全科医学》2020年第7期1125-1127,1250,共4页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2017KY706,2017KY163)。

摘　　要：目的探讨脓毒症患者脂氧素A4表达水平在其预后预测中的价值。方法选择2017年6月—2018年3月浙江省台州医院收治的脓毒症患者40例,收集患者基线资料、危重评分、生化指标、住ICU时间、住院时间及28 d生存情况;ELASA法检测血浆脂氧素A4(lipoxin A4,LXA4)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-6(interleukin-6,IL-6)、转化生长因子-β1(transforming growth factor-β1,TGF-β1)、促血管生成素-1(angiogenin-1,ANG-1)、促血管生成素-2(angiogenin-2,ANG-2)等表达水平;采用ROC、Kaplan-Meier曲线法分析LXA4在脓毒症患者预后的预测价值。结果根据LXA4表达水平,将患者分为L组(LXA4≤55 ng/mL,21例)和H组(LXA4>55 ng/mL,19例);L组患者的APACHEⅡ、ANG-2、ANG-2/ANG-1水平明显高于H组,差异有统计学意义(均P<0.05);H组患者TGF-β1、ANG-1高于L组,差异有统计学意义(均P<0.05);ROC曲线显示LXA4对脓毒症患者28 d病死率有较好的预测价值(AUC:0.824,P=0.003);Kaplan-Meier法得出H组患者28 d累计生存率明显高于L组,差异有统计学意义(log-rank test P=0.045)。结论脓毒症患者LXA4表达水平对其预后具有较好的预测价值。Objective To explore the prognostic value of lipoxin A4 in patients with sepsis.Methods From June 2017 to March 2018,40 patients with sepsis were admitted to the Department of Critical Care Medicine,Taizhou Hospital of Zhejiang Province.The general information,severity score,biochemical parameters,ICU stay,hospital stay and 28-day survival were collected.Plasma levels of lipoxin A4,TNF-α,IL-6,TGF-β1,ANG-1 and ANG-2 were detected by ELA-SA.The prognostic value of lipoxin A4 in patients with sepsis was analyzed by ROC and Kaplan-Meier.Results Ac-cording to the expression level of lipoxin A4,sepsis patients were divided into L group(lipoxin A4≤55 ng/mL,n=21)and H group(lipoxin A4>55 ng/mL,n=19).APACHEⅡ,ANG-2 and ANG-2/ANG-1 in L group were signifi-cantly higher than those in the H group(all P<0.05).The TGF-β1,ANG-1 in H group were higher than the L group(all P<0.05).ROC curve showed that lipoxin A4 has a good predictive value for 28-day mortality in patients with sep-sis(AUC:0.824;P=0.003).Kaplan-Meier survival method shown that the 28-day cumulative survival rate of patients in H group was significantly higher than that of the L group(log-rank test P=0.045).Conclusion The expression lev-el of lipoxin A4 has a good predictive effect on the risk of death from sepsis.

关 键 词：脓毒症 脂氧素A4 促炎症消退 血管内皮细胞 预后 

分 类 号：R631[医药卫生—外科学] R446[医药卫生—临床医学]