Yaroustovsky Michael, Rogalskaya Ekaterina, Plyushch Marina, Klimovich Ludmila, Samsonova Nataliya, Abramyan Marina
Federal State Budget Institution "Bakulev National Scientific and Practical Center for Cardiovascular Surgery" of the Ministry of Healthcare of the Russian Federation (Bakulev NSPCCS), Moscow, Russia.
Int J Inflam. 2017;2017:3495293. doi: 10.1155/2017/3495293. Epub 2017 Apr 12.
. To analyse the clinical informativity of the neutrophil oxidative response level ("Response") during an Endotoxin Activity Assay (EAA) as a new biomarker defining the indications and effectiveness of intensive care in cardiac surgical patients with septic complications. . Blood samples were taken from 198 adult patients who were admitted to the ICU after cardiac surgery (SIRS: 34, MODS: 36, and sepsis: 128). The composite of laboratory studies included CRP, PCT, EAA with "Response" level, and presepsin. . 83% of patients had a "normal" neutrophil response, 12% of patients had a low neutrophil response, and 5% of patients had a critically low neutrophil response. Patients with critically low responses had the lowest values of the EAA and the highest concentrations of PSP and D-dimer ( < 0.05). . EAA results should be interpreted with the level of neutrophil response. "Response" > 0.5 has a negative predictive value; the EAA < 0.6 at "Response" < 0.5 may indicate a high level of endotoxaemia.
分析内毒素活性测定(EAA)期间中性粒细胞氧化反应水平(“反应”)作为一种新的生物标志物的临床信息性,该生物标志物可确定患有脓毒症并发症的心脏手术患者重症监护的指征和有效性。从198例心脏手术后入住重症监护病房的成年患者中采集血样(全身炎症反应综合征:34例,多器官功能障碍综合征:36例,脓毒症:128例)。实验室检查组合包括CRP、降钙素原、具有“反应”水平的EAA和可溶性髓系细胞触发受体-1。83%的患者中性粒细胞反应“正常”,12%的患者中性粒细胞反应低,5%的患者中性粒细胞反应极低。中性粒细胞反应极低的患者EAA值最低,可溶性髓系细胞触发受体-1和D-二聚体浓度最高(P<0.05)。EAA结果应结合中性粒细胞反应水平进行解读。“反应”>0.5具有阴性预测价值;“反应”<0.5时EAA<0.6可能表明内毒素血症水平较高。