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[凝溶胶蛋白水平在危重症患者预后评估中的应用]

[Gelsolin level for prognostic evaluation in patients with critically illness].

作者信息

Zhang Xiao-qin, Pu Hong, Wang Yi-ping, Li Jia-jia, Pan Ling-ai, Huang You-jin, Li Chun-ling

机构信息

Intensive Care Unit,Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital,Chengdu 610072,China.

Intensive Care Unit, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, China.

出版信息

Zhejiang Da Xue Xue Bao Yi Xue Ban. 2014 Sep;43(5):541-5. doi: 10.3785/j.issn.1008-9292.2014.09.009.

Abstract

OBJECTIVE

To investigate the changes of plasma gelsolin level in patients with critical illness and its application in prognostic evaluation.

METHODS

Ninety six critically ill patients admitted in ICU of Sichuan Provincial People's Hospital from February 2012 to December 2013 were enrolled in the prospective cohort study. Plasma gelsolin levels were detected with enzyme linked immunosorbent assay (ELISA) at admission (d1), d2, d4 and d8 after admission, and also detected in blood samples of 186 healthy subjects as controls. Logistic regression model was used to analyze the relationship between the level of plasma gelsolin and prognosis of patients.

RESULTS

The average levels of plasma gelsolin were significantly lower in critically ill patients than those in control subjects (F=1986.37, P<0.01). There was significant difference in overall level of gelsolin between survival patients and fatal patients (F=16.691, P<0.01). APACHE Ⅱ score was associated with survival outcomes (r=0.489, P=0.009); the APACHE Ⅱ score was significantly higher in fatal patients than that in survival patients (29.5±7.7 vs 22.1±5.7, t=5.375, P<0.01). There was a negative correlation between plasma gelsolin levels and fatal outcomes (r=-0.512, P<0.01). Logistic regression analysis showed that the overall plasma gelsolin levels and the last measured level was a prognostic factor for critically ill patients (P<0.05).

CONCLUSION

Plasma gelsolin levels are correlated with the severity of critically ill patients, and plasma gelsolin can be used as indicator of prognosis.

摘要

目的

探讨危重症患者血浆凝溶胶蛋白水平的变化及其在预后评估中的应用。

方法

选取2012年2月至2013年12月在四川省人民医院重症监护病房收治的96例危重症患者进行前瞻性队列研究。入院时(d1)、入院后d2、d4和d8采用酶联免疫吸附测定法(ELISA)检测血浆凝溶胶蛋白水平,并选取186例健康受试者的血样作为对照进行检测。采用Logistic回归模型分析血浆凝溶胶蛋白水平与患者预后的关系。

结果

危重症患者血浆凝溶胶蛋白的平均水平显著低于对照组(F = 1986.37,P < 0.01)。存活患者与死亡患者的凝溶胶蛋白总体水平存在显著差异(F = 16.691,P < 0.01)。急性生理与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分与生存结局相关(r = 0.489,P = 0.009);死亡患者的APACHEⅡ评分显著高于存活患者(29.5±7.7 vs 22.1±5.7,t = 5.375,P < 0.01)。血浆凝溶胶蛋白水平与死亡结局呈负相关(r = -0.512,P < 0.01)。Logistic回归分析显示,血浆凝溶胶蛋白总体水平及最后一次测量水平是危重症患者的预后因素(P < 0.05)。

结论

血浆凝溶胶蛋白水平与危重症患者的病情严重程度相关,血浆凝溶胶蛋白可作为预后指标。

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