血清Syndecan-1、Endocan-1及炎症因子评估脓毒症患者病情严重程度及预后的价值  

Value of serum Syndecan-1,Endocan-1 and inflammatory factor levels in evaluating severity and prognosis of sepsis patients

作　　者：吴静静 张福森[1] 李冬梅 刘霞[3] WU Jingjing;ZHANG Fusen;LI Dongmei;LIU Xia(Comprehensive ICU;Pregnant Woman Rescue Center,Tai′an Municipal Central Hospital,Tai′an,Shandong 271000,China;Fourth Department of Radiotherapy,Tai′an Municipal Tumor Prevention and Treatment Hospital,Tai′an,Shandong 271000,China)

机构地区：[1]山东省泰安市中心医院综合ICU,山东泰安271000 [2]山东省泰安市中心医院孕产妇救治中心,山东泰安271000 [3]山东省泰安市肿瘤防治院放疗四科,山东泰安271000

出　　处：《检验医学与临床》2024年第14期2053-2056,2061,共5页Laboratory Medicine and Clinic

基　　金：山东省泰安市科技发展计划(引导计划)项目(2019NS212)。

摘　　要：目的 探讨血清多配体聚糖-1(Syndecan-1)、内皮细胞特异分子1(Endocan-1)及炎症因子评估脓毒症患者病情严重程度及预后的临床价值。方法 选取2019年10月至2020年6月泰安市中心医院收治的122例脓毒症患者作为研究组,按照病情严重程度分为轻度脓毒症组(63例)、重度脓毒症组(41例)和脓毒症休克组(18例)。另选取同期收治的68例全身炎症反应综合征患者作为对照组。分析血清Syndecan-1、Endocan-1表达水平与炎症因子、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ评分)、快速序贯器官衰竭评分(qSOFA评分)的相关性,以及血清Syndecan-1、Endocan-1对脓毒症患者预后的预测效能。结果 研究组与对照组APACHEⅡ评分、qSOFA评分及血清Syndecan-1、Endocan-1表达水平比较,差异均有统计学意义(P<0.05);脓毒症休克组患者血清Syndecan-1和Endocan-1表达水平、APACHEⅡ评分、qSOFA评分,以及血清降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素-6(IL-6)水平均高于轻度脓毒症组和重度脓毒症组(P<0.05),且重度脓毒症组高于轻度脓毒症组(P<0.05)。血清Syndecan-1、Endocan-1表达水平与各项炎症因子水平及APACHEⅡ评分、qSOFA评分均呈正相关(P<0.05)。血清Syndecan-1和Endocan-1联合预测脓毒症患者预后的效能优于二者单独预测(Z_(二者联合-Syndecan-1)=2.842,P=0.004 5;Z_(二者联合-Endocan-1)=3.054,P=0.002 3)。结论 血清Syndecan-1、Endocan-1表达水平与脓毒症患者病情严重程度有关,二者联合检测对脓毒症患者预后具有较高的预测效能。Objective To explore the clinical value of serum Syndecan-1,Endocan-1 and inflammatory factors levels in evaluating the severity and prognosis of sepsis patients.Methods A total of 122 patients with sepsis admitted and treated in Tai′an Municipal Central Hospital from October 2019 to June 2020 were selected as the study group and divided into the mild sepsis group(63 cases),severe sepsis group(41 cases)and septic shock group(18 cases)according to the severity of disease condition.Other 68 patients with systemic inflammatory response syndrome admitted and treated during the same period served as the control group.The correlation between serum Syndecan-1 and Endocan-1 with inflammatory factor levels with Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score,Quick Sepsis Related Organ Failure Assessment(qSOFA)score was analyzed.The predictive efficiency of serum Syndecan-1 and Endocan-1 on the prognosis of sepsis patients was analyzed.Results There were statistically significant differences in APACHEⅡscores,qSOFA scores,serum Syndecan-1 and Endocan-1 expression levels between the study group and control group(P<0.05).The serum Syndecan-1 and Endocan-1 levels,APACHEⅡscore,qSOFA score and serum procalcitonin(PCT),C-reactive protein(CRP)and interleukin-6(IL-6)levels in the septic shock group were higher than those in the mild sepsis group and severe sepsis group(P<0.05),moreover the severe sepsis group was higher than the mild sepsis group(P<0.05).The serum Syndecan-1 and Endocan-1 expression levels were positively correlated with the various inflammatory factors levels,APACHEⅡscore and qSOFA score(P<0.05).The efficiency of serum Syndecan-1 and Endocan-1 combined prediction for the prognosis of sepsis patients was superior to the prediction alone(Z_(combination-Syndecan-1)=2.842,P=0.0045;Z_(combination-Endocan-1)=3.054,P=0.0023).Conclusion The expression levels of serum Syndecan-1 and Endocan-1 are related to the severity of sepsis patients,and the combined detection has high predictive efficiency f

关 键 词：多配体聚糖-1 内皮细胞特异分子1 脓毒症 C反应蛋白 白细胞介素-6 

分 类 号：R446.112[医药卫生—诊断学] R631.2[医药卫生—临床医学]