血清klastatin 水平降低与脓毒性休克患者 28 天死亡率相关。
Lower serum kallistatin level is associated with 28-day mortality in patients with septic shock.
机构信息
Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Emergency Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
出版信息
J Crit Care. 2018 Dec;48:328-333. doi: 10.1016/j.jcrc.2018.09.008. Epub 2018 Sep 11.
PURPOSE
Investigation for whether serum levels of kallistatin, vascular cell adhesion molecule-1 (VCAM-1), and E-selectin are associated with outcomes in patients with septic shock MATERIAL AND METHODS: Biomarker levels were measured using blood samples from patients with septic shock at admission, 24 h, and 72 h and from healthy volunteers. The primary outcome was 28-day mortality.
RESULTS
Fifty-eight survivors, fourteen non-survivors, and six healthy volunteers were enrolled. Serum kallistatin level was lower and serum VCAM-1 and E-selectin levels were higher in patients at admission compared with healthy volunteers. Serum kallistatin levels were higher in survivors compared with non-survivors at all time points (4.4 μg/mL [2.9-6.1] vs. 2.5 μg/mL [2.1-5.0], P = 0.019 at admission; 4.3 μg/mL [3.3-5.2] vs. 3.2 μg/mL [2.2-3.8], P = 0.004 at 24 h; 3.1 μg/mL [2.5-4.2] vs. 2.3 μg/mL [1.7-3.1], P = 0.012 at 72 h), while VCAM-1 and E-selectin levels showed no difference. In the multivariable analysis, serum kallistatin level at 24 h was independently associated with 28-day mortality (OR, 0.29; 95% CI, 0.08-0.69, P = 0.024).
CONCLUSIONS
Lower serum kallistatin level at 24 h was independently associated with 28-day mortality in patients with septic shock.
目的
探讨血清激肽释放酶相关肽（kallistatin）、血管细胞黏附分子-1（VCAM-1）和 E-选择素水平与脓毒性休克患者结局的关系。
材料与方法
采用入院时、24 小时和 72 小时采集的脓毒性休克患者和健康志愿者的血液样本，测量生物标志物水平。主要结局为 28 天死亡率。
结果
共纳入 58 例存活者、14 例非存活者和 6 例健康志愿者。与健康志愿者相比，入院时患者的血清激肽释放酶相关肽水平较低，而血清 VCAM-1 和 E-选择素水平较高。与非存活者相比，存活者在所有时间点的血清激肽释放酶相关肽水平均较高（入院时 4.4μg/mL[2.9-6.1]比 2.5μg/mL[2.1-5.0]，P=0.019；24 小时时 4.3μg/mL[3.3-5.2]比 3.2μg/mL[2.2-3.8]，P=0.004；72 小时时 3.1μg/mL[2.5-4.2]比 2.3μg/mL[1.7-3.1]，P=0.012），而 VCAM-1 和 E-选择素水平则无差异。多变量分析显示，24 小时时的血清激肽释放酶相关肽水平与 28 天死亡率独立相关（OR，0.29；95%CI，0.08-0.69，P=0.024）。
结论
脓毒性休克患者 24 小时时的血清激肽释放酶相关肽水平较低与 28 天死亡率独立相关。
Zotero 插件