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入院时血清CXCL12水平可预测严重脓毒症/脓毒性休克患者的死亡率。

Serum CXCL12 levels on hospital admission predict mortality in patients with severe sepsis/septic shock.

作者信息

Franchini Stefano, Marcianò Teodoro, Sorlini Cristina, Campochiaro Corrado, Tresoldi Moreno, Sabbadini Maria Grazia, Dagna Lorenzo

机构信息

Emergency Department, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Vita-Salute San Raffaele University, Milan, Italy.

出版信息

Am J Emerg Med. 2015 Dec;33(12):1802-4. doi: 10.1016/j.ajem.2015.08.047. Epub 2015 Aug 29.

Abstract

OBJECTIVES

We evaluated serum levels of CXCL12 in patients with severe sepsis/septic shock and controls.

METHODS

We enrolled 27 patients admitted to our emergency department with severe sepsis/septic shock and 20 healthy controls. Complete blood count, serum levels of CXCL12, C-reactive protein, lactate, Charlson comorbidity index, sequential organ failure score on hospital admission, and inhospital mortality were evaluated at baseline (T0) and after 24 hours (T24).

RESULTS

Mean serum levels of CXCL12 were higher in patients with severe sepsis/septic shock than in healthy subjects (3121 vs 1991 pg/mL; P < .001). We also found that patient who survived had lower serum levels of CXCL12 than those who died (2630 vs 3957 pg/mL; P < .001) but still higher than controls (2630 vs 1991 pg/mL; P = .001) on admission. CXCL12 serum levels were higher in patients with serum lactate greater than 4 mmol/L.

CONCLUSIONS

Our data suggest a possible role for CXCL12 as a prognostic marker in severe sepsis/septic shock and give background evidence for larger trials to evaluate the pathophysiologic and clinical role of CXCL12 in sepsis, with respect to other markers of inflammation and hypoxia.

摘要

目的

我们评估了严重脓毒症/脓毒性休克患者和对照组的血清CXCL12水平。

方法

我们纳入了27例因严重脓毒症/脓毒性休克入住我院急诊科的患者以及20名健康对照者。在基线(T0)和24小时后(T24)评估全血细胞计数、血清CXCL12水平、C反应蛋白、乳酸水平、Charlson合并症指数、入院时序贯器官衰竭评分以及住院死亡率。

结果

严重脓毒症/脓毒性休克患者的血清CXCL12平均水平高于健康受试者(3121对1991 pg/mL;P <.001)。我们还发现,存活患者的血清CXCL12水平低于死亡患者(2630对3957 pg/mL;P <.001),但入院时仍高于对照组(2630对1991 pg/mL;P =.001)。血清乳酸水平大于4 mmol/L的患者CXCL12血清水平更高。

结论

我们的数据表明CXCL12可能作为严重脓毒症/脓毒性休克的预后标志物,并为更大规模试验提供背景证据,以评估CXCL12在脓毒症中相对于其他炎症和缺氧标志物的病理生理和临床作用。

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