Fujian Provincial Key Laboratory of Burn and Trauma, Fujian Burn Institute, Fujian Burn Medical Center, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
Fujian Provincial Key Laboratory of Burn and Trauma, Fujian Burn Institute, Fujian Burn Medical Center, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
J Surg Res. 2021 Sep;265:1-10. doi: 10.1016/j.jss.2021.01.012. Epub 2021 Apr 14.
Severe burn injury activates shock, inflammation, and blood cell system, but inappropriate reactions may lead to adverse outcomes. Soluble Fas ligand (sFasL) participates in apoptosis and inflammatory response. The circulating sFasL levels we investigated in association with the burn severity, shock, inflammation, blood cells, and mortality in patients with severe burns.
A total of 56 patients with severe burns were recruited. The levels of sFasL and the biomarkers reflecting shock, organ damage, inflammation, and blood cells at 48 h postburn were analyzed. We compared the practical situation of patients that stratified by median sFasL levels and investigated the predictive value of sFasL for mortality.
High circulating sFasL levels were associated with the higher degrees of burn index, shock index, lactate, N-terminal probrain natriuretic peptide, total bilirubin, blood urea nitrogen, creatinine, tumor necrosis factor-α, interleukin-1β, interleukin-8, intercellular adhesion molecule 1, and complement 3, and the lower degrees of oxygenation index, lymphocytes, and platelets. Multiple linear regression analysis showed that the higher tumor necrosis factor-α (P < 0.001) and the lower oxygenation index (P = 0.031) and lymphocytes (P = 0.043) were associated with the higher sFasL. High sFasL (a unit is 50 ng/L) (odds ratio [OR] 5.50 [95% CI 1.04-29.20], P = 0.045) was an independent predictor of increased mortality by multivariate logistic regression analysis.
High circulating sFasL at 48 h postburn in patients with severe burns reflect shock, proinflammatory response, organ damage, and lymphocyte reductions and predict 30-day mortality.
严重烧伤激活休克、炎症和血细胞系统，但不适当的反应可能导致不良后果。可溶性 Fas 配体（sFasL）参与细胞凋亡和炎症反应。我们研究了循环 sFasL 水平与严重烧伤患者烧伤严重程度、休克、炎症、血细胞和死亡率的关系。
共纳入 56 例严重烧伤患者。分析烧伤后 48 小时内 sFasL 水平和反映休克、器官损伤、炎症和血细胞的生物标志物。我们比较了按 sFasL 中位数分层的患者的实际情况，并探讨了 sFasL 对死亡率的预测价值。
高循环 sFasL 水平与烧伤指数、休克指数、乳酸、N 末端脑利钠肽前体、总胆红素、血尿素氮、肌酐、肿瘤坏死因子-α、白细胞介素-1β、白细胞介素-8、细胞间黏附分子 1 和补体 3 较高，氧合指数、淋巴细胞和血小板较低有关。多元线性回归分析显示，较高的肿瘤坏死因子-α（P<0.001）和较低的氧合指数（P=0.031）和淋巴细胞（P=0.043）与较高的 sFasL 相关。多因素 logistic 回归分析显示，烧伤后 48 小时高 sFasL（单位为 50ng/L）（比值比[OR] 5.50[95%CI 1.04-29.20]，P=0.045）是增加死亡率的独立预测因子。
严重烧伤患者烧伤后 48 小时循环 sFasL 升高反映了休克、促炎反应、器官损伤和淋巴细胞减少，并预测 30 天死亡率。
