From the Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine , Seoul , Republic of Korea.
Infect Dis (Lond). 2015 Jun;47(6):393-8. doi: 10.3109/00365548.2014.1001999. Epub 2015 Mar 6.
Endothelial damage developing in severe sepsis or septic shock results in multiorgan dysfunction. An increased circulating endothelial cell (CEC) count represents a novel marker of endothelial damage, which has been reported in cases of severe sepsis or septic shock. The aim of this study was to evaluate the clinical significance of CECs in patients with severe sepsis or septic shock.
CECs were evaluated and quantified by flow cytometry using plasma collected from patients with severe sepsis or septic shock who were admitted to a medical intensive care unit from February 2011 to August 2011.
During the study period, 77 patients were enrolled. The median CEC count was 350 cells/ml (range 0-15 984 cells/ml). There was no significant difference between cases of severe sepsis and septic shock [163 cells/ml (0-15 984 cells/ml) vs 363 cells/ml (0-7884 cells/ml), p = 0.507]. There were no correlations between the number of CECs and inflammatory markers. CEC counts were significantly increased in non-survivors compared to survivors [588.5 cells/ml (1-15 984 cells/ml) vs 292 cells/ml (0-12 882 cells/ml), p = 0.044] within 28 days. The sequential-related organ failure assessment score, CEC counts ≥ 500 cells/ml and blood lactate levels were significantly associated with 28 day mortality.
CEC counts were higher in non-survivors of severe sepsis or septic shock and could be used as a biomarker to predict the prognosis in these patients.
严重脓毒症或感染性休克中发生的内皮损伤导致多器官功能障碍。循环内皮细胞（CEC）计数的增加代表内皮损伤的一种新标志物，在严重脓毒症或感染性休克病例中已有报道。本研究旨在评估 CEC 在严重脓毒症或感染性休克患者中的临床意义。
通过流式细胞术评估和定量分析 2011 年 2 月至 8 月入住重症监护病房的严重脓毒症或感染性休克患者的血浆中 CEC。
在研究期间，共纳入 77 例患者。CEC 的中位数为 350 个细胞/ml（范围 0-15984 个细胞/ml）。严重脓毒症和感染性休克之间的 CEC 计数无显著差异[163 个细胞/ml（0-15984 个细胞/ml）比 363 个细胞/ml（0-7884 个细胞/ml），p=0.507]。CEC 数量与炎症标志物之间无相关性。与幸存者相比，非幸存者的 CEC 计数显著增加[588.5 个细胞/ml（1-15984 个细胞/ml）比 292 个细胞/ml（0-12882 个细胞/ml），p=0.044]在 28 天内。序贯性器官衰竭评估评分、CEC 计数≥500 个细胞/ml 和血乳酸水平与 28 天死亡率显著相关。
严重脓毒症或感染性休克的非幸存者 CEC 计数较高，可作为预测这些患者预后的生物标志物。
