Recombinant human thrombopoietin in alleviating endothelial cell injury in sepsis  

作　　者：Yun Xie Hui Lv Daonan Chen Peijie Huang Shaohong Wu Hongchao Shi Qi Zhao Ruilan Wang 

机构地区：[1]Department of Critical Care Medicine,Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,China

出　　处：《Journal of Intensive Medicine》2024年第3期384-392,共9页重症医学（英文）

基　　金：supported by grants from the Shenkang Municipal Hospital emerging Frontier technology joint project(grant no.SHDC12019131);the National Natural Science Foundation of China(grant no.82202423);the Clinical Research Innovation Plan of Shanghai General Hospital(grant no.CCTR-2022B04);the 3rd Sansheng TCP Young and Middleaged Scientific Research Funding;Shanghai Jiao Tong University“Medicine-Engineering Interdisciplinary Research Fund”(grant no.YG2021QN79);National Key Clinical Specialist Construction Project(grant no.Z155080000004);Shanghai Committee(grant no.23Y31900100).

摘　　要：Background To evaluate the effect of recombinant human thrombopoietin(rhTPO)on clinical prognosis by exploring changes in endothelial cell injury markers and inflammatory factors in patients with sepsis after treatment with rhTPO.Methods This retrospective observational study involved patients with sepsis(diagnosed according to Sepsis 3.0)admitted to Shanghai General Hospital intensive care unit from January 1,2019 to December 31,2022.Patients were divided into two groups(control and rhTPO)according to whether they received rhTPO.Baseline information,clinical data,prognosis,and survival status of the patients,as well as inflammatory factors and immune function indicators were collected.The main monitoring indicators were endothelial cell-specific molecule(ESM-1),human heparin-binding protein(HBP),and CD31;secondary monitoring indicators were interleukin(IL)-6,tumor necrosis factor(TNF)-α,extravascular lung water index,platelet,antithrombin III,fibrinogen,and international normalized ratio.We used intraperitoneal injection of lipopolysaccharide(LPS)to establish a mouse model of sepsis.Mice were randomly divided into four groups:normal saline,LPS,LPS+rhTPO,and LPS+rhTPO+LY294002.Plasma indicators in mice were measured by enzyme-linked immunosorbent assay.Results A total of 84 patients were included in the study.After 7 days of treatment,ESM-1 decreased more significantly in the rhTPO group than in the control group compared with day 1(median=38.6[interquartile range,IQR:7.2 to 67.8]pg/mL vs.median=23.0[IQR:−15.7 to 51.5]pg/mL,P=0.008).HBP and CD31 also decreased significantly in the rhTPO group compared with the control group(median=59.6[IQR:−1.9 to 91.9]pg/mL vs.median=2.4[IQR:−23.2 to 43.2]pg/mL;median=2.4[IQR:0.4 to 3.5]pg/mL vs.median=−0.6[IQR:−2.2 to 0.8]pg/mL,P<0.001).Inflammatory markers IL-6 and TNF-αdecreased more significantly in the rhTPO group than in the control group compared with day 1(median=46.0[IQR:15.8 to 99.1]pg/mL vs.median=31.2[IQR:19.7 to 171.0]pg/mL,P<0.001;median=17.2[IQR:6.4 to

关 键 词：THROMBOPOIETIN SEPSIS Endothelial cells 

分 类 号：R459.7[医药卫生—急诊医学]