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危重症患者血清瘦素监测的诊断价值及其与肿瘤坏死因子-α的相关性：一项前瞻性观察研究。

The diagnostic value of serum leptin monitoring and its correlation with tumor necrosis factor-alpha in critically ill patients: a prospective observational study.

机构信息

Department of Anesthesiology, Tanta University Hospital, Tanta, Egypt.

出版信息

Crit Care. 2010;14(2):R33. doi: 10.1186/cc8911. Epub 2010 Mar 15.

DOI:10.1186/cc8911
PMID:20230641
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2887140/
Abstract

INTRODUCTION

Severe infection and sepsis are common causes of morbidity and mortality. Early diagnosis in critically ill patients is important to reduce these complications. The present study was conducted to determine the role of serum leptin at early diagnosis and differentiation between patients with manifestations of systemic inflammatory response syndrome (SIRS) and those with sepsis in patients suffering from a broad range of diseases in the intensive care unit (ICU) and its correlation with other biomarkers, such as C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha).

METHODS

One hundred and six adult ICU patients were observed. CRP, leptin, IL-6 and TNF-alpha were compared among the following groups: sepsis group (n = 40), SIRS group (n = 34) and non-SIRS group (n = 32). Patients were classified into these groups at the time of blood analysis for these biomarkers.

RESULTS

Non-significant differences were observed among patients in different groups regarding biomarkers on the day of ICU admission. On the second day of ICU admission, significant elevation of leptin, IL-6 and TNF-alpha occurred in the SIRS and sepsis groups. Delayed elevation of CRP started on the fourth day of ICU admission in patients with sepsis. At the end of the first week, only CRP level was elevated in septic patients.

CONCLUSIONS

Serum leptin correlates well with serum level of IL-6 and TNF-alpha. Leptin helps to differentiate SIRS from non-SIRS patients. CRP is a classic marker of sepsis but is of late onset.

摘要

简介

严重感染和败血症是发病率和死亡率的常见原因。在危重病患者中早期诊断对于减少这些并发症很重要。本研究旨在确定血清瘦素在早期诊断中的作用，并区分患有全身性炎症反应综合征（SIRS）和败血症的患者，这些患者患有广泛的疾病，在重症监护病房（ICU）中，并确定其与其他生物标志物（如 C 反应蛋白（CRP）、白细胞介素 6（IL-6）和肿瘤坏死因子-α（TNF-α））的相关性。

方法

观察了 106 名成年 ICU 患者。比较了 CRP、瘦素、IL-6 和 TNF-α 在以下各组之间的差异：败血症组（n = 40）、SIRS 组（n = 34）和非 SIRS 组（n = 32）。在进行这些生物标志物的血液分析时，根据这些标志物将患者分为这些组。

结果

在 ICU 入院当天，不同组的患者之间在生物标志物方面没有观察到显著差异。在 ICU 入院的第二天，SIRS 和败血症组的瘦素、IL-6 和 TNF-α显著升高。败血症患者 CRP 的延迟升高始于 ICU 入院后的第四天。在第一周结束时，只有败血症患者的 CRP 水平升高。

结论

血清瘦素与血清 IL-6 和 TNF-α水平密切相关。瘦素有助于区分 SIRS 和非 SIRS 患者。CRP 是败血症的经典标志物，但发病较晚。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63d1/2887140/b4693e96e610/cc8911-6.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63d1/2887140/49584a899287/cc8911-1.jpg
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