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败血症患者酶法溶血磷脂酰胆碱(LPC)检测数据的临床意义。

Clinical significance of enzymatic lysophosphatidylcholine (LPC) assay data in patients with sepsis.

机构信息

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.

出版信息

Eur J Clin Microbiol Infect Dis. 2012 Aug;31(8):1805-10. doi: 10.1007/s10096-011-1505-6. Epub 2011 Dec 14.

Abstract

Lysophosphatidylcholine (LPC) has been suggested to serve as a useful prognostic marker for sepsis. However, existing LPC assays are complicated, time-consuming, and of limited application in real clinical situations. Thus, we investigated the serum LPC levels in sepsis patients using an enzymatic assay and analyzed the correlations between the serum LPC concentration and clinical characteristics. We prospectively collected blood samples from suspected sepsis patients, commencing on day 1 of sepsis. We analyzed all samples using an enzymatic assay. Additionally, we analyzed the serum LPC concentrations in a control group of 21 healthy blood donors. A total of 105 patients who fulfilled the sepsis criteria were included. The mean serum LPC concentration was 43.49 ± 33.09 μmol/L in sepsis patients, which was much lower than that of 21 healthy controls (234.68 ± 30.33 μmol/L, p<0.001). Bacteremic sepsis was associated with a lower serum LPC concentration than non-bacteremic sepsis (34.8 ± 26.85 vs. 49.05 ± 35.63 μmol/L, p<0.05). No difference in serum LPC concentration was evident between survivors and non-survivors. The serum LPC concentration tended to decrease with the severity of sepsis. The day 1 serum LPC concentration was decreased in patients with sepsis, especially when bacteremia was present. However, the serum LPC level did not correlate with disease severity and did not predict mortality from sepsis.

摘要

溶血磷脂酰胆碱(LPC)已被证明可作为脓毒症的有用预后标志物。然而,现有的 LPC 检测方法复杂、耗时,在实际临床情况下的应用有限。因此,我们使用酶法检测了脓毒症患者的血清 LPC 水平,并分析了血清 LPC 浓度与临床特征之间的相关性。我们前瞻性地收集了疑似脓毒症患者的血液样本,从脓毒症的第 1 天开始。我们使用酶法分析了所有样本。此外,我们还分析了 21 名健康献血者对照组的血清 LPC 浓度。共纳入 105 名符合脓毒症标准的患者。脓毒症患者的血清 LPC 浓度平均值为 43.49 ± 33.09 μmol/L,明显低于 21 名健康对照者(234.68 ± 30.33 μmol/L,p<0.001)。菌血症性脓毒症患者的血清 LPC 浓度低于非菌血症性脓毒症患者(34.8 ± 26.85 与 49.05 ± 35.63 μmol/L,p<0.05)。存活者与非存活者之间的血清 LPC 浓度无差异。血清 LPC 浓度随着脓毒症的严重程度而降低。脓毒症患者的第 1 天血清 LPC 浓度降低,尤其是存在菌血症时。然而,血清 LPC 水平与疾病严重程度无关,也不能预测脓毒症的死亡率。

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