循环内皮祖细胞可能预测急诊科成年严重脓毒症患者的预后。
Circulating endothelial progenitor cells may predict outcomes in adult patients with severe sepsis in the emergency department.
作者信息
Kung Chia-Te, Su Chih-Min, Chen Chao Tung, Cheng Hsien-Hung, Chang Meng-Wei, Hung Chih-Wei, Hung Shin-Chiang, Chang Wen-Neng, Tsai Nai-Wen, Wang Hung-Chen, Su Yu-Jih, Huang Chin-Cheng, Lin Wei-Che, Cheng Ben-Chung, Chang Ya-Ting, Lu Cheng-Hsien
机构信息
Department of Emergency Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Emergency Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan.
出版信息
Clin Chim Acta. 2016 Apr 1;455:1-6. doi: 10.1016/j.cca.2016.01.015. Epub 2016 Jan 18.
BACKGROUND
Dysfunctional and decreased numbers of endothelial progenitor cells (EPCs) may play an essential role in the initiation of organ dysfunction caused by severe sepsis. We evaluated the role of serial circulating EPCs in outcomes of patients with severe sepsis.
METHODS
In total, 101 adult patients with severe sepsis and septic shock were evaluated. Circulating levels of EPCs (CD133(+)/CD34(+) and KDR(+)/CD34(+) cells) were determined at different time points.
RESULTS
The levels of CD133(+)/CD34(+) and KDR(+)/CD34(+) EPCs were significantly higher in the severe sepsis group than in the healthy controls. Levels of CD133(+)/CD34(+) EPCs were significantly higher in the mortality group than in the survival group on day 1 of admission (p<0.05), but decreased significantly with time among non-survivors (p<0.05), and were lowest on day 4 at the emergency department. The Sequential Organ Failure Assessment score and number of CD133(+)/CD34(+) EPCs on admission were independently associated with in-hospital mortality.
CONCLUSION
The level of CD133(+)/CD34(+) EPCs on admission is independently associated with in-hospital mortality, and the trend of a sharp decrease in the number of EPCs is related to outcomes in patients with severe sepsis.
背景
内皮祖细胞（EPCs）功能失调及数量减少可能在严重脓毒症所致器官功能障碍的起始过程中起关键作用。我们评估了连续循环EPCs在严重脓毒症患者预后中的作用。
方法
共评估了101例成年严重脓毒症和脓毒性休克患者。在不同时间点测定EPCs（CD133(+)/CD34(+)和KDR(+)/CD34(+)细胞）的循环水平。
结果
严重脓毒症组CD133(+)/CD34(+)和KDR(+)/CD34(+) EPCs水平显著高于健康对照组。入院第1天，死亡组CD133(+)/CD34(+) EPCs水平显著高于存活组（p<0.05），但在非存活者中随时间显著下降（p<0.05），在急诊科第4天时最低。入院时序贯器官衰竭评估评分和CD133(+)/CD34(+) EPCs数量与院内死亡率独立相关。
结论
入院时CD133(+)/CD34(+) EPCs水平与院内死亡率独立相关，EPCs数量急剧下降的趋势与严重脓毒症患者的预后相关。
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