Lorente Leonardo, Martín María M, Abreu-González Pedro, de la Cruz Thais, Ferreres José, Solé-Violán Jordi, Labarta Lorenzo, Díaz César, Jiménez Alejandro, Borreguero-León Juan M
Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n. La Laguna, 38320, Santa Cruz de Tenerife, Spain.
Intensive Care Unit, Hospital Universitario Nuestra Señora Candelaria, Crta Rosario s/n. Santa Cruz Tenerife, 38010, Spain.
J Crit Care. 2015 Aug;30(4):860.e1-6. doi: 10.1016/j.jcrc.2015.03.023. Epub 2015 Apr 1.
Melatonin in septic patients has been scarcely explored and only in studies of small sample size (maximum 20 patients). Thus, the objective of this study was to determine whether serum melatonin levels are associated with severity, oxidant and inflammatory state, and mortality in a large series of septic patients.
A prospective, observational, multicenter study was performed in 6 Spanish intensive care units with 201 severe septic patients. Serum levels of melatonin were measured at moment of severe sepsis diagnosis. The end point was 30-day mortality.
Non-surviving patients (n = 71) showed higher serum melatonin levels (P < .001) than survivors (n = 130). Multiple logistic regression analysis showed that serum melatonin levels were associated with 30-day mortality (odds ratio, 1.022; 95% confidence interval, 1.001-1.043; P = .04), controlling for serum tumor necrosis factor-α levels, serum interleukin 6 levels and age. Serum melatonin levels were positively associated with serum levels of malondialdehyde as biomarker of oxidative stress, interleukin-6 and lactate, and with SOFA score.
The novel finding of our study was that serum melatonin levels are associated with mortality in septic patients.
褪黑素在脓毒症患者中的研究较少，且仅在小样本量（最多20例患者）研究中进行过。因此，本研究的目的是确定在大量脓毒症患者中，血清褪黑素水平是否与病情严重程度、氧化及炎症状态和死亡率相关。
在西班牙6个重症监护病房对201例严重脓毒症患者进行了一项前瞻性、观察性、多中心研究。在严重脓毒症诊断时测定血清褪黑素水平。终点为30天死亡率。
非存活患者（n = 71）的血清褪黑素水平高于存活患者（n = 130）（P <.001）。多因素logistic回归分析显示，在控制血清肿瘤坏死因子-α水平、血清白细胞介素6水平和年龄后，血清褪黑素水平与30天死亡率相关（比值比，1.022；95%置信区间，1.001 - 1.043；P =.04）。血清褪黑素水平与作为氧化应激生物标志物的丙二醛血清水平、白细胞介素-6和乳酸呈正相关，并与序贯器官衰竭评估（SOFA）评分相关。
我们研究的新发现是血清褪黑素水平与脓毒症患者的死亡率相关。
