sEPCR在脓毒症患者中的表达及临床意义  

Expression and clinical significance of sEPCR in patients with sepsis

作　　者：钱骏 黄中伟[1,2] 徐建如[2] 陆仁飞 王海燕[2] QIAN Jun;HUANG Zhongwei;XU Jianru;LU Renfei;WANG Haiyan(Department of Emergency Medicine,Affiliated Hospital of Nantong University,Jiangsu Province,Nantong226021,China;Department of Emergency,Third People’s Hospital of Nantong City,Jiangsu Province,Nantong226000,China;Clinical Laboratory,Third People’s Hospital of Nantong City,Jiangsu Province,Nantong226000,China)

机构地区：[1]南通大学附属医院急诊医学科,江苏南通226021 [2]江苏省南通市第三人民医院急诊科,江苏南通226000 [3]江苏省南通市第三人民医院检验科,江苏南通226000

出　　处：《中国医药导报》2021年第10期88-91,共4页China Medical Herald

基　　金：江苏省南通市市级科技计划(指导性)项目(MSZ18201)。

摘　　要：目的探讨可溶性内皮细胞蛋白质C受体(sEPCR)在脓毒症患者血浆中的表达及临床意义。方法选取2018年10月—2019年10月在江苏省南通市第三人民医院(以下简称“我院”)治疗的脓毒症患者100例,根据病情程度将其分为两组,脓毒症组65例,脓毒性休克组35例,同时选取我院同期健康体检者50名作为对照组。检测各组血浆sEPCR水平,比较各组血浆sEPCR水平差异,同时分析不同预后患者间的差异,采用受试者工作特征(ROC)曲线分析血浆sEPCR水平对患者预后的预测价值。结果脓毒性休克组入院时血浆sEPCR水平明显高于脓毒症组和对照组,且脓毒症组高于对照组,差异均有统计学意义(均P<0.05)。脓毒症组、脓毒性休克组死亡患者入院时、治疗3 d后血浆sEPCR水平明显高于存活患者,差异均有统计学意义(均P<0.05);脓毒症组、脓毒性休克组死亡患者血浆sEPCR水平变化值明显低于存活患者,差异均有统计学意义(均P<0.05);入院时、治疗后3 d血浆sEPCR水平及其变化值预测患者死亡的ROC曲线下面积分别为0.674、0.884、0.848(均P<0.05)。结论血浆sEPCR在脓毒症患者中表达升高,与患者病情严重程度有一定关系,在预测患者预后方面有一定临床意义。Objective To investigate the expression and clinical significance of soluble endothelial cell protein C receptor(sEPCR)in plasma of sepsis patients.Methods A total of 100 patients with sepsis who were treated in Third People’s Hospital of Nantong City,Jiangsu Province(hereinafter referred to as“our hospital”)from October 2018 to October 2019 were selected and they were divided into two groups according to the severity of the disease,including 65 patients in the sepsis group and 35 patients in the septic shock group.Meanwhile,50 healthy subjects in our hospital during the same period were selected as the control group.Plasma sEPCR level of each group was detected,and the differences in plasma sEPCR level among each group were compared,and the differences among patients with different prognosis were analyzed.Receiver operating characteristic(ROC)curve was used to analyze the prognostic value of plasma sEPCR level in the prognosis of patients.Results Plasma sEPCR level in the septic shock group was significantly higher than that in the sepsis group and the control group at admission,and the sepsis group was higher than the control group,and the differences were statistically significant(all P<0.05).Plasma sEPCR level of died patients in the sepsis group and the septic shock group was significantly higher than that in the surviving patients at admission and after three days of treatment,and the differences were statistically significant(all P<0.05).The changes of plasma sEPCR level of died patients in the sepsis group and the septic shock group were significantly lower than those in the surviving patients,and the differences were statistically significant(all P<0.05).The area under the ROC curve for predicting the death of patients with sEPCR at admission and three days after treatment and its changes were 0.674,0.884 and 0.848,respectively(all P<0.05).Conclusion The increased expression of plasma SEPCR in patients with sepsis is related to the severity of the disease,and has certain clinical significance in pr

关 键 词：血浆可溶性内皮细胞蛋白C受体 脓毒症 脓毒性休克 临床意义 

分 类 号：R459.7[医药卫生—急诊医学]