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脓毒症患者的血浆内皮素-1水平

Plasma endothelin-1 levels in septic patients.

作者信息

Piechota Mariusz, Banach Maciej, Irzmanski Robert, Barylski Marcin, Piechota-Urbanska Magdalena, Kowalski Jan, Pawlicki Lucjan

机构信息

Department of Anaesthesiology and Intensive Care Unit, Medical University of Lodz, Poland.

出版信息

J Intensive Care Med. 2007 Jul-Aug;22(4):232-9. doi: 10.1177/0885066607301444.

Abstract

Dysfunction of the vascular endothelium (ET) causes an increase in serum ET-1 concentration, as observed in septic patients. It was assumed that in this patient population the ET-1 level correlates with the degree of sepsis severity, including the level of organ dysfunction and, in particular, the level of circulatory dysfunction. The aim of the present study was to assess the relationship between levels of ET-1 and levels of N-terminal brain natriuretic propeptide (NT-proBNP), procalcitonin (PCT), and C-reactive protein (CRP), as well as the Sepsis-related Organ Failure Assessment (SOFA) score in septic patients. PCT and CRP were used to estimate the level of sepsis severity; the SOFA score was used to estimate multiorgan dysfunction; and NT-proBNP was used as a marker of cardiac dysfunction. Twenty patients with sepsis and severe sepsis were included in the study. Blood serum ET-1, NT-proBNP, PCT, and CRP concentrations were determined at specific time intervals, and the SOFA score was calculated. Mean ET-1, NT-proBNP, PCT, and CRP concentrations were 8.39 pg/ml +/- 6.39 pg/mL, 140.80 pg/mL +/- 84.65 pg/mL, 22.32 ng/mL +/- 97.41 ng/mL, and 128.51 mg/L +/- 79.05 mg/L, respectively. Correlation between ET-1 levels and levels of NT-proBNP, PCT, and CRP was .3879 (P < .001), .358 (P < .001), and .225 (P = .011), respectively. Mean SOFA score was 6.31 pts +/- 3.75 pts. Correlation between the ET-1 levels and SOFA score was .470 (P < .001). Six patients (30%) died during the observation period of 28 days. ET-1 levels correlate with levels of NT-proBNP, PCT, and CRP, as well as the SOFA score in septic patients.

摘要

血管内皮功能障碍(ET)会导致血清ET-1浓度升高,脓毒症患者中就有这种情况。据推测,在这类患者群体中,ET-1水平与脓毒症严重程度相关,包括器官功能障碍程度,尤其是循环功能障碍程度。本研究的目的是评估脓毒症患者中ET-1水平与N端脑钠肽前体(NT-proBNP)、降钙素原(PCT)和C反应蛋白(CRP)水平之间的关系,以及脓毒症相关器官功能衰竭评估(SOFA)评分。PCT和CRP用于评估脓毒症严重程度;SOFA评分用于评估多器官功能障碍;NT-proBNP用作心脏功能障碍的标志物。本研究纳入了20例脓毒症和严重脓毒症患者。在特定时间间隔测定血清ET-1、NT-proBNP、PCT和CRP浓度,并计算SOFA评分。ET-1、NT-proBNP、PCT和CRP的平均浓度分别为8.39 pg/ml±6.39 pg/mL、140.80 pg/mL±84.65 pg/mL、22.32 ng/mL±97.41 ng/mL和128.51 mg/L±79.05 mg/L。ET-1水平与NT-proBNP、PCT和CRP水平的相关性分别为0.3879(P<0.001)、0.358(P<0.001)和0.225(P=0.011)。平均SOFA评分为6.31分±3.75分。ET-1水平与SOFA评分的相关性为0.470(P<0.001)。在28天观察期内6例患者(30%)死亡。脓毒症患者中ET-1水平与NT-proBNP、PCT和CRP水平以及SOFA评分相关。

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