研究血浆 sCD138 在肾综合征出血热患者中的表达。

Study on expression of plasma sCD138 in patients with hemorrhagic fever with renal syndrome.

机构信息

Center of Infectious Diseases, Tangdu Hospital, Air-force Military Medical University, 569 Xinsi Rd, Baqiao District, Xi'an, Shaanxi, 710038, China.

出版信息

BMC Infect Dis. 2018 Mar 1;18(1):100. doi: 10.1186/s12879-018-3005-0.

DOI:10.1186/s12879-018-3005-0

PMID:29490629

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5831831/

Abstract

BACKGROUND

Until now, there is non-specific treatment, and exploring early and novel biomarkers to determine the disease severity and prognosis of hemorrhagic fever with renal syndrome (HFRS) would be of importance for clinician to take systematic and timely intervention. This study observed the expression of plasma sCD138, a soluble component shedding from the glycocalyx (GCX) to the circulating blood, and evaluated its predictive value on disease severity and prognosis of HFRS.

METHODS

One hundred and seventy-six patients with HFRS who were treated at our center between January 2011 and December 2013 were randomly enrolled in this study. The patients were divided into a mild-type group, a moderate-type group, a severe-type group and a critical-type group according to the HFRS criteria for clinical classification. Thirty-five blood samples from healthy subjects were obtained as the controls. The concentrations of sCD138 were detected using enzyme linked immunosorbent assay (ELISA). The levels of prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib), albumin (ALB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), white blood cells (WBC), platelets (PLT), glucose (GLU), blood urea nitrogen (BUN) and serum creatinine (Scr) in the samples were routinely tested. The levels of sCD138 among the different types were compared; the correlation among sCD138 and the laboratory parameters mentioned above were analyzed. The predictive effectiveness for prognosis of sCD138 was evaluated using the receiver operating characteristic (ROC) curve analysis.

RESULTS

Except for the mild-type, the levels of sCD138 in the moderate-, severe- and critical-type patients during the acute stage were significantly higher than that of the convalescent stage and the control (P<0.05). With the aggravation of the disease, the levels of sCD138 during the acute stage had an increasing tendency, while demonstrated no significant difference among the moderate-, severe- and critical-type patients (P>0.05). sCD138 was negatively correlated with Fib, PLT and ALB, and was positively correlated with WBC and AST (P<0.05). sCD138 demonstrated predictive effectiveness for prognosis with the area under the curve (AUC) of 0.778 (P<0.001).

CONCLUSION

Dynamic detection of plasma sCD138 might be benefit to evaluating the disease severity and prognosis of the patients with HFRS.

摘要

背景

到目前为止，还没有特异性治疗方法，探索早期和新型生物标志物来确定肾综合征出血热（HFRS）的疾病严重程度和预后对于临床医生进行系统和及时的干预非常重要。本研究观察了血浆 sCD138 的表达，sCD138 是糖萼（GCX）释放到循环血液中的可溶性成分，并评估了其对 HFRS 疾病严重程度和预后的预测价值。

方法

本研究纳入了 2011 年 1 月至 2013 年 12 月在我院接受治疗的 176 例 HFRS 患者，将其随机分为轻症组、中症组、重症组和危重症组，根据 HFRS 临床分类标准进行临床分类。收集 35 例健康受试者的血液样本作为对照组。采用酶联免疫吸附试验（ELISA）检测 sCD138 浓度。常规检测各组样本的凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（Fib）、白蛋白（ALB）、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、白细胞（WBC）、血小板（PLT）、血糖（GLU）、血尿素氮（BUN）和血清肌酐（Scr）。比较不同类型患者之间 sCD138 的水平；分析 sCD138 与上述实验室参数的相关性。采用受试者工作特征（ROC）曲线分析评估 sCD138 对预后的预测效果。

结果

除轻症组外，中症、重症和危重症患者急性期的 sCD138 水平均明显高于恢复期和对照组（P<0.05）。随着病情加重，急性期 sCD138 水平呈升高趋势，但中症、重症和危重症患者之间无显著差异（P>0.05）。sCD138 与 Fib、PLT 和 ALB 呈负相关，与 WBC 和 AST 呈正相关（P<0.05）。sCD138 对预后有预测作用，曲线下面积（AUC）为 0.778（P<0.001）。