循环内皮祖细胞与脓毒症器官功能障碍呈负相关。
Circulating endothelial progenitor cells inversely associate with organ dysfunction in sepsis.
机构信息
Division of Pulmonary, Allergy, and Critical Care Medicine, Grady Memorial Hospital, Emory University School of Medicine, 49 Jesse Hill Jr Drive, SE FOB, Pulmonary, Atlanta, GA 30303, USA.
出版信息
Intensive Care Med. 2012 Mar;38(3):429-36. doi: 10.1007/s00134-012-2480-9. Epub 2012 Feb 14.
PURPOSE
Endothelial dysfunction is a primary contributor to sepsis-related organ dysfunction and death. In sepsis animal models, endothelial progenitor cells (EPC) have contributed to vascular repair. The role of endothelial progenitor cells as a biomarker for organ dysfunction is still unknown. We hypothesized that circulating numbers of endothelial progenitor cells would be associated with improved outcomes in sepsis.
METHODS
Prospective, observational single-center cohort study in adult intensive care units at Grady Memorial Hospital, an affiliate of Emory University, from July 2007 through April 2009. Peripheral blood was obtained from 95 patients with sepsis, 37 intensive care unit controls, and 51 healthy controls, of whom only 86 patients with sepsis were used in the analysis because we were not able to obtain enough blood in 9 sepsis patients. Clinical data were obtained, and organ dysfunction was measured by Sepsis-Related Organ Failure Assessment (SOFA) score. Endothelial progenitor cells were assessed by a colony-forming unit (CFU) assay in which peripheral blood mononuclear cells were isolated using Ficoll density-gradient centrifugation and cultured in growth media.
RESULTS
The patients with sepsis had significantly lower mean endothelial progenitor cell colony counts compared with intensive care unit controls (p = 0.035) and healthy controls (p = 0.0005). There was no difference in colony counts between ICU controls and healthy controls (p = 0.81). In the sepsis patients, EPC CFU numbers inversely associated with SOFA score, adjusting for mortality (r (2) = 0.05, p = 0.04).
CONCLUSION
Increased circulating endothelial progenitor cells inversely correlate with organ dysfunction in sepsis patients.
目的
内皮功能障碍是导致脓毒症相关器官功能障碍和死亡的主要原因。在脓毒症动物模型中，内皮祖细胞（EPC）有助于血管修复。内皮祖细胞作为器官功能障碍的生物标志物的作用尚不清楚。我们假设循环内皮祖细胞数量与脓毒症患者的转归相关。
方法
这是一项 2007 年 7 月至 2009 年 4 月在埃默里大学附属医院 Grady Memorial Hospital 的成人重症监护病房进行的前瞻性、观察性单中心队列研究。从脓毒症患者（95 例）、重症监护病房对照者（37 例）和健康对照者（51 例）中采集外周血，其中只有 86 例脓毒症患者被纳入分析，因为我们无法从 9 例脓毒症患者中获得足够的血液。收集临床数据，通过脓毒症相关器官衰竭评估（SOFA）评分来测量器官功能障碍。采用集落形成单位（CFU）测定法评估内皮祖细胞，该方法通过 Ficoll 密度梯度离心分离外周血单核细胞，并在生长培养基中培养。
结果
与重症监护病房对照者（p = 0.035）和健康对照者（p = 0.0005）相比，脓毒症患者的平均内皮祖细胞集落计数明显较低。重症监护病房对照者和健康对照者的集落计数无差异（p = 0.81）。在脓毒症患者中，EPC CFU 数量与 SOFA 评分呈负相关，调整死亡率后（r²=0.05，p=0.04）。
结论
循环内皮祖细胞的增加与脓毒症患者的器官功能障碍呈负相关。
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