Department of Emergency Medicine, Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, P.R. China.
Department of Geriatric Medicine, Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, P.R. China.
Mol Med Rep. 2018 Jan;17(1):1791-1798. doi: 10.3892/mmr.2017.8034. Epub 2017 Nov 13.
Sepsis remains one of the leading contributors to mortality rates in the intensive care unit (ICU) and emergency intensive care unit (EICU). Therefore, any treatments against the agents which produce sepsis in a medical emergency, are welcome. Elevated serum levels of lipoprotein‑associated phospholipase A2 (Lp‑PLA2) have been reported in a small cohort of patients with inflammation. The present study evaluated serum levels of Lp‑PLA2 in patients with sepsis and investigated the role of Lp‑PLA2 in sepsis. The investigation involved the selection of 151 patients with sepsis admitted to the emergency department of the Affiliated Hospital of Nantong University (Nantong, China) and 30 healthy controls. All patients (39 with sepsis, 55 with severe sepsis and 57 with septic shock) were examined on admission to the EICU. A complete blood count was performed, and serum levels of Lp‑PLA2, C‑reactive protein, procalcitonin, and interleukin 6, sequential organ failure (SOFA) scores and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were determined on hospital admission. The EICU and overall mortality rates were evaluated at baseline. The present study also assessed various laboratory parameters, clinical data and inflammatory cytokines. The patient follow up duration was 90 days. The data suggested that the serum levels of Lp‑PLA2 on admission to the EICU in patients with sepsis were elevated, compared with those in healthy controls. The concentrations of Lp‑PLA2 were correlated with the severity of disease, and were significantly associated with experimental markers of inflammation and established prognostic scores. In the total cohort, persistently elevated levels of Lp‑PLA2 on admission for EICU treatment was a predictor of poor prognosis, and provided superior diagnostic use, compared with the prognostic scoring systems, including SOFA or APACHE II scores. Taken together, the results suggested that Lp‑PLA2, with respect to other markers of inflammation, may have a role as a prognostic marker in sepsis, and provide background evidence for further trials to evaluate the clinical and pathophysiologic roles of Lp‑PLA2 in sepsis. Persistently elevated serum concentrations of Lp‑PLA2 indicated an unfavorable outcome in patients with sepsis. In addition, the results indicated the potential role of Lp‑PLA2 as a prognostic biomarker in patients with sepsis during the early course of EICU treatment.
脓毒症仍然是重症监护病房（ICU）和急诊重症监护病房（EICU）死亡率的主要原因之一。因此，在医疗急救中对抗任何产生脓毒症的药物的治疗都是受欢迎的。在一小部分炎症患者中，已报道血清脂蛋白相关磷脂酶 A2（Lp-PLA2）水平升高。本研究评估了脓毒症患者的血清 Lp-PLA2 水平，并研究了 Lp-PLA2 在脓毒症中的作用。该研究选择了 151 名南通大学附属医院（中国南通）急诊部收治的脓毒症患者和 30 名健康对照者。所有患者（39 例脓毒症、55 例严重脓毒症和 57 例脓毒性休克）在进入 EICU 时进行了检查。进行了全血细胞计数，并在入院时测定了血清 Lp-PLA2、C-反应蛋白、降钙素原和白细胞介素 6、序贯器官衰竭（SOFA）评分和急性生理学和慢性健康评估 II（APACHE II）评分。在基线时评估了 EICU 和总体死亡率。本研究还评估了各种实验室参数、临床数据和炎症细胞因子。患者随访时间为 90 天。数据表明，脓毒症患者 EICU 入院时血清 Lp-PLA2 水平升高，与健康对照组相比。Lp-PLA2 的浓度与疾病的严重程度相关，与炎症的实验标志物和既定的预后评分显著相关。在总队列中，EICU 治疗入院时持续升高的 Lp-PLA2 水平是预后不良的预测指标，与 SOFA 或 APACHE II 评分等预后评分系统相比，具有更好的诊断作用。综上所述，结果表明，Lp-PLA2 与其他炎症标志物相比，可能作为脓毒症的预后标志物发挥作用，并为进一步评估 Lp-PLA2 在脓毒症中的临床和病理生理作用的试验提供背景证据。脓毒症患者血清 Lp-PLA2 浓度持续升高提示预后不良。此外，结果表明 Lp-PLA2 在 EICU 治疗早期作为脓毒症患者预后生物标志物的潜在作用。
