Department of Critical Care Medicine, The First Hospital of China Medical University, North Nanjing Street 155, Shenyang, 110001, Liaoning Province, China.
BMC Anesthesiol. 2021 Jan 22;21(1):26. doi: 10.1186/s12871-021-01241-9.
Soluble CD40 ligand (sCD40L) exhibits proinflammatory and procoagulant effects. Recent data indicated that sCD40L plays a significant role in septic patients. The aim of the present study was to determine sCD40L changes in surgical patients without sepsis (SWS) and surgical sepsis patients (SS) during the first 3 days after intensive care unit (ICU) admission and to observe the association between sCD40L and mortality.
Time changes in sCD40L levels were assessed for 3 days after ICU admission in 49 patients with SS and compared with those in 19 SWS patients. Serum sCD40L concentration was detected by ELISA. Survival at 28 days served as the endpoint.
SS had significantly higher sCD40L levels than SWS and control patients. We observed an association between sCD40L levels ≥1028.75 pg/mL at day 2 and 28-day mortality (odds ratio = 7.888; 95% confidence interval = 1.758 to 35.395; P = 0.007). We could not discover any significant differences in sex, presence of septic shock, site of infection, length of stay in the ICU, PaO/FiO ratio, incidence of AKI, ARDS, or type of surgery between nonsurvivors and survivors.
Septic patients show persistently higher circulating sCD40L levels in the first 3 days after ICU admission, and serum sCD40L levels are associated with the mortality of patients with sepsis. Thus, serum sCD40L may be used as a reliable biomarker and therapeutic target in sepsis.
可溶性 CD40 配体（sCD40L）具有促炎和促凝作用。最近的数据表明，sCD40L 在脓毒症患者中发挥着重要作用。本研究旨在确定无脓毒症的外科患者（SWS）和外科脓毒症患者（SS）在入住重症监护病房（ICU）后前 3 天 sCD40L 的变化，并观察 sCD40L 与死亡率之间的关系。
评估了 49 例 SS 患者和 19 例 SWS 患者在入住 ICU 后 3 天内 sCD40L 水平的时间变化，并与对照组进行了比较。采用 ELISA 法检测血清 sCD40L 浓度。28 天的生存率作为终点。
SS 的 sCD40L 水平明显高于 SWS 和对照组。我们观察到第 2 天 sCD40L 水平≥1028.75pg/ml 与 28 天死亡率之间存在关联（比值比=7.888；95%置信区间=1.758 至 35.395；P=0.007）。我们未发现死亡组和存活组在性别、脓毒性休克、感染部位、入住 ICU 时间、PaO/FiO 比值、急性肾损伤、急性呼吸窘迫综合征发生率或手术类型方面存在显著差异。
脓毒症患者在入住 ICU 后前 3 天内持续显示出更高的循环 sCD40L 水平，血清 sCD40L 水平与脓毒症患者的死亡率相关。因此，血清 sCD40L 可能被用作脓毒症的可靠生物标志物和治疗靶点。
