血清内皮细胞特异性分子-1水平对老年多器官功能不全综合征患者病情严重程度及预后评估的价值  

Value of serum Endocan in the assessment of disease severity and prognosis for elderly multiple organ dysfunction syndrome patients

作　　者：蒯凤 韩艺 周苏明 Kuai Feng;Han Yi;Zhou Suming(Department of Rehabilitation Medicine,Yancheng No.1 People's Hospital,Yancheng 224000,China;Department of Aged ICU,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]盐城市第一人民医院康复医学科,盐城224000 [2]南京医科大学第一附属医院老年重症医学科,南京210029

出　　处：《中华老年医学杂志》2023年第11期1291-1295,共5页Chinese Journal of Geriatrics

摘　　要：目的探讨血清内皮细胞特异性分子-1(Endocan)水平与老年多器官功能不全综合征(MODS)患者病情严重程度及其预后的关系.方法选取盐城市第一人民医院ICU老年住院患者75例,入室后24 h内进行急性生理与慢性健康状况评分(APACHEⅡ评分)及MODS评分,分为MODS组(35例)及非MODS组(40例);同时选取40例老年体检者作为对照组.采用酶联免疫吸附试验(ELISA)检测血清Endocan水平;再根据28 d临床结局将患者分为存活组及病死组,分别探讨各组间Endocan水平的差异,并绘制受试者工作特征(ROC)曲线,探讨Endocan与老年MODS患者病情严重程度及预后的关系.结果MODS组Endocan水平高于非MODS组[(622.3±149.2)ng/L比(433.1±189.7)ng/L,P<0.001];APACHEⅡ评分及MODS评分越高,血清Endocan水平越高;血清Endocan水平、MODS评分以及两者联合的ROC曲线下面积分别为0.791、0.806和0.820(P>0.05);APACHEⅡ评分以及两者联合的ROC曲线下面积分别为0.763、0.799和0.803(P>0.05);存活组的血清Endocan水平低于病死组[(444.6±193.6)ng/L比(618.2±149.5)ng/L,P<0.001].结论Endocan水平与老年MODS患者病情严重程度及预后相关.Objective To examine the significance of serum Endocan levels in evaluating the severity of disease and predicting the prognosis for elderly patients with multiple organ dysfunction syndrome(MODS).Methods Seventy-five elderly patients from the Department of Geriatric ICU at the First Affiliated Hospital of Nanjing Medical University were selected and divided into two groups:the non-MODS group and the MODS group.This division was based on the levels of acute physiology and chronic health evaluation II(APACHE I)scores and MODS scores within 24 hours of admission.Additionally,40 elderly individuals undergoing physical examination were included as a control group.Venous blood samples were collected from all participants to detect the levels of Endocan using ELISA.The patients were further categorized into the survival group and the death group based on their clinical outcome within 28 days.The Endocan levels in all groups were compared.and receiver operating characteristic(ROC)curves were generated to assess the value of Endocan in determining the severity of the disease and predicting prognosis in elderly MODS patients.Results The levels of Endocan were found to be higher in the MODS group compared to the non-MODS and control groups[(622.3±149.2)ng/L us.(433.1±189.7)ng/LP<0.001].Furthermore,patients with higher APACHE II and MODS scores exhibited higher levels of Endocan.The area under the ROC curve(AUC)for Endocan,MODS score,and Endocan+MODS score were 0.791,0.806,and 0.820,respectively(P>0.05).Similarly,the AUC for Endocan,APACHE II score,and Endocan+APACHE I score were 0.763,0.799,and 0.803,respectively(P>0.05).Interestingly,the survival group had lower levels of Endocan compared to the death group[(444.6±193.6)ng/L vs.(618.2±149.5)ng/L,P<0.001].Conclusions Endocan can be utilized as a noteworthy indicator,which is associated with the seriousness of illness and the prognosis for elderly patients with multiple organ dysfunction syndrome(MODS).

关 键 词：多器官功能不全综合征 血清内皮细胞特异性分子-1 预后 

分 类 号：R459.7[医药卫生—急诊医学]