非存活的脓毒症患者血清可溶性CD40配体（sCD40L）水平持续高于存活患者。

Non-survivor septic patients have persistently higher serum sCD40L levels than survivors.

作者信息

Lorente Leonardo, Martín María M, Pérez-Cejas Antonia, Ferreres José, Solé-Violán Jordi, Labarta Lorenzo, Díaz César, Jiménez Alejandro

机构信息

Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n, La Laguna 38320, Tenerife, Spain.

Intensive Care Unit, Hospital Universitario Nuestra Señora Candelaria, Crta Rosario s/n, Santa Cruz Tenerife 38010, Spain.

出版信息

J Crit Care. 2017 Oct;41:177-182. doi: 10.1016/j.jcrc.2017.05.021. Epub 2017 May 24.

DOI:10.1016/j.jcrc.2017.05.021

Abstract

INTRODUCTION

Soluble CD40 ligand (sCD40L) is a protein with proinflammatory and prothrombotic effects. Previously we found higher circulating sCD40L levels in non-survivor than in survivor patients at sepsis diagnosis. Now some questions arise such as how are serum sCD40L levels during the first week of severe sepsis?, is there an association between serum sCD40L levels during the first week and mortality?, and serum sCD40L levels during the first week could be used as sepsis mortality biomarker?. This study was developed to answer these asks.

METHODS

Study from 6 Spanish Intensive Care Units with 291 severe septic patients. There were determined serum levels of sCD40L and tumor necrosis factor (TNF)-alpha during the first week. The end-point study was 30-day mortality.

RESULTS

We found that serum sCD40L at days 1, 4, and 8 could predict mortality at 30days, and are associated with mortality.

CONCLUSIONS

The novel findings of our study were that there were higher serum sCD40L levels persistently during the first week in non-survivor than in survivor patients, that there is an association between serum sCD40L levels during the first week and sepsis mortality, and that serum sCD40L levels during the first week could be used as sepsis mortality biomarker.

摘要

引言

可溶性CD40配体（sCD40L）是一种具有促炎和促血栓形成作用的蛋白质。此前我们发现，脓毒症诊断时，非存活患者的循环sCD40L水平高于存活患者。现在出现了一些问题，如严重脓毒症第一周的血清sCD40L水平如何？第一周的血清sCD40L水平与死亡率之间是否存在关联？第一周的血清sCD40L水平能否用作脓毒症死亡率的生物标志物？本研究旨在回答这些问题。

方法

对来自6个西班牙重症监护病房的291例严重脓毒症患者进行研究。测定第一周的血清sCD40L和肿瘤坏死因子（TNF）-α水平。研究的终点是30天死亡率。

结果

我们发现第1天、第4天和第8天的血清sCD40L可预测30天死亡率，并与死亡率相关。

结论

我们研究的新发现是，非存活患者在第一周内血清sCD40L水平持续高于存活患者，第一周的血清sCD40L水平与脓毒症死亡率之间存在关联，且第一周的血清sCD40L水平可作为脓毒症死亡率的生物标志物。