外周血内皮祖细胞对脓毒性休克患者早期预后的评估价值  

Early prognostic value of endothelial progenitor cells from human peripheral blood in patients with septic shock

作　　者：潘振涛 陈晓丹 周银超 杨磊 袁园 黄巧娟 王俊聪 叶恭杰[1] PAN Zhentao;CHEN Xiaodan;ZHOU Yinchao;YANG Lei;YUAN Yuan;HANG Qiaojuan;WANG Juncong;YE Gongjie(Ningbo Medical Center Lihuili Hospital,Ningbo 315040,Zhejiang,China;不详)

机构地区：[1]宁波市医疗中心李惠利医院,宁波大学附属李惠利医院,宁波315040 [2]宁波大学研究生学院

出　　处：《现代实用医学》2022年第4期433-436,F0002,共5页Modern Practical Medicine

基　　金：宁波市自然科学基金(2019A610276)。

摘　　要：目的探讨外周血内皮祖细胞(EPCs)在脓毒性休克患者早期预后中的评估价值。方法选择91例脓毒性休克患者为研究组,根据28 d预后分为死亡组和存活组,另选45例健康成人为对照组。检测外周血EPCs的相对数量,同时记录研究对象基本资料,入科第1、3和7天的体温、C-反应蛋白(CRP)、前降钙素(PCT)、血白细胞(WBC)、白介素-6(IL-6)、白介素-10(IL-10)、机械通气时间和ICU平均住院时间。分析影响患者预后的危险因素,以及EPCs对患者预后的评估价值。结果死亡组EPCs少于对照组和存活组,存活组与对照组EPCs差异无统计学意义。死亡组入科第1天IL-6高于存活组,第1、3和7天PCT高于存活组。EPCs和APACHEⅡ评分是脓毒性休克患者死亡的独立危险因素。ROC曲线分析发现,EPCs约登指数为0.508,具有中等预测价值,曲线下面积(AUC)为0.79(95%CI=0.68~0.89),最佳临界值为0.108%时,敏感性77.2%,特异性73.5%。结论外周血EPCs对脓毒性休克患者早期预后具有较好的评估价值。Objective To explore the value of endothelial progenitor cells(EPCs)for the early prognosis of patients with septic shock.Methods A total of 91 cases with septic shock were included in the study.The study subjects were divided into death group and survival group according to the 28-day prognosis,and another 45 healthy adults were selected as control group.EPCs were isolated by density gradient centrifugation,and flow cytometry was used to detecte the relative number of EPCs.The basic data,C-reactive protein(CRP),procalcitonin(PCT),white blood cell(WBC),interleukin-6(IL-6),interleukin-10(IL-10),mechanical ventilation time,and average length of stay in ICU were recorded.Binary Logistic regression was used to analyze the prognostic risk factors of septic shock patients.ROC was used to analyze the predictive value of EPCs in the prognosis of septic shock.Results Compared with control group and survival group,EPCs in death group was reduced,while there was no difference between control group and survival group.On the 1 st,3 rd and 7 th day,there was no significant difference in body temperature,CRP,WB C and IL-10 between survival group and death group.On the 1 st day,PCT and IL-6 of death group were increased.On the 3 rd and 7 th day,PCT increased in death group.Compared with control group and survival group,there was no difference in mechanical ventilation time and the average length of stay in the ICU.The results of binary Logistic regression analysis showed that EPCs and APACHEⅡwere independent death risk factors in patients with septic shock.ROC curve analysis showed that EPCs had a Yoden index of 0.508,which had moderate predictive value.The AUC for the death prediction in septic shock patients were 0.79[95%CI=0.79(0.68~0.89)].When the best cut-off was 0.108%,the sensitivity was 77.2%and the specificity was 73.5%for the death prediction in septic shock patients.Conclusions EPCs may have a certain value in the early prognosis evaluation of the patients with septic shock.

关 键 词：脓毒性休克 脓毒症 内皮祖细胞 预后 

分 类 号：R631[医药卫生—外科学]