载脂蛋白 A1 炎性指数与脓毒症和感染性休克患者器官衰竭的严重程度相关，并可预测其严重程度。
HDL inflammatory index correlates with and predicts severity of organ failure in patients with sepsis and septic shock.
机构信息
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.
出版信息
PLoS One. 2018 Sep 14;13(9):e0203813. doi: 10.1371/journal.pone.0203813. eCollection 2018.
OBJECTIVE
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.
METHODS
A prospective cohort study of adult ED sepsis patients enrolled within 24 hours.
RESULTS
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).
CONCLUSION
HII correlated with SOFA and predicted 48-hour SOFA score in early sepsis. Future studies are needed to delineate potential mechanisms.
TRIAL REGISTRATION
NCT02370186. Registered February 24, 2015.
目的
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。
方法
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。
结果
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）。
结论
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。
试验注册
NCT02370186。2015 年 2 月 24 日注册。
Zotero 插件