Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, United States of America.
Department of Medicine, Eastern Virginia Medical School, Norfolk, VA, United States of America.
PLoS One. 2018 Sep 14;13(9):e0203813. doi: 10.1371/journal.pone.0203813. eCollection 2018.
High density lipoprotein (HDL) is important for defense against sepsis but becomes dysfunctional (Dys-HDL) during inflammation. We hypothesize that Dys-HDL correlates with organ dysfunction (sequential organ failure assessment (SOFA) score) early sepsis.
A prospective cohort study of adult ED sepsis patients enrolled within 24 hours.
Eighty eight patients were analyzed. Dys-HDL (expressed as HDL inflammatory index (HII)) correlated with SOFA at enrollment (r = 0.23, p = 0.024) and at 48 hours (r = 0.24, p = 0.026) but HII change over the first 48 hours did not correlate with change in SOFA (r = 0.06, p = 0.56). Enrollment HII was significantly different in patients with most severe organ failure (2.31, IQR 1.33-5.2) compared to less severe organ failure (1.81, IQR 1.23-2.64, p = 0.043). Change in HII over 48 hours was significantly different for in-hospital non-survivors (-0.45, IQR-2.6, -0.14 p = 0.015) and for 28-day non-survivors (-1.12, IQR -1.52, 0.12, p = 0.044). In a multivariable linear regression equation (R2 = 0.13), for each unit HII increase, 48-hour SOFA increased by 0.72 (p = 0.009).
HII correlated with SOFA and predicted 48-hour SOFA score in early sepsis. Future studies are needed to delineate potential mechanisms.
NCT02370186. Registered February 24, 2015.
高密度脂蛋白（HDL）对于防御败血症很重要，但在炎症期间会变得功能失调（Dys-HDL）。我们假设 Dys-HDL 与早期败血症的器官功能障碍（序贯器官衰竭评估（SOFA）评分）相关。
对成人 ED 败血症患者进行前瞻性队列研究，在 24 小时内入组。
分析了 88 例患者。Dys-HDL（表示为 HDL 炎症指数（HII））与入院时（r = 0.23，p = 0.024）和 48 小时时（r = 0.24，p = 0.026）的 SOFA 相关，但在最初 48 小时内 HII 的变化与 SOFA 的变化不相关（r = 0.06，p = 0.56）。在器官衰竭最严重的患者（2.31，IQR 1.33-5.2）中，HII 的入组值与器官衰竭较轻的患者（1.81，IQR 1.23-2.64，p = 0.043）有显著差异。48 小时内 HII 的变化在院内非幸存者（-0.45，IQR-2.6，-0.14，p = 0.015）和 28 天非幸存者（-1.12，IQR-1.52，0.12，p = 0.044）之间有显著差异。在多元线性回归方程中（R2 = 0.13），HII 每增加一个单位，48 小时 SOFA 增加 0.72（p = 0.009）。
HII 与 SOFA 相关，并预测早期败血症的 48 小时 SOFA 评分。需要进一步的研究来阐明潜在的机制。
NCT02370186。2015 年 2 月 24 日注册。
