Dominioni L, Dionigi R, Zanello M, Monico R, Cremaschi R, Dionigi R, Ballabio A, Massa M, Comelli M, Dal Ri P
Arch Surg. 1987 Feb;122(2):141-6. doi: 10.1001/archsurg.1987.01400140023001.
In a series of 135 patients with severe surgical infections, we determined the sepsis score and the plasma level of the acute-phase proteins alpha-1-acid glycoprotein, alpha 1-antitrypsin, complement factor B, and C3. The initial sepsis score was a strong determinant of survival: in survivors it was significantly lower than in nonsurvivors. Only 8% of patients with a sepsis score above 20 survived. At the onset of severe sepsis, the plasma levels of all four acute-phase proteins were significantly lower in nonsurvivors. A significant elevation of C3a levels in the plasma of both surviving and nonsurviving patients indicated marked consumption of complement components in all patients with severe sepsis. A linear equation was developed to predict survival: sepsis index of survival (SIS) % = 121 + 0.26 (complement factor B) + 0.36 (alpha-1-acid glycoprotein)-6 (sepsis score). Based on our analysis, at the onset of severe sepsis, an SIS of 50% or more can correctly predict 88% of survivors and an SIS less than 50% can correctly predict 86% of nonsurvivors several days in advance of clinical outcome.
在一组135例严重外科感染患者中，我们测定了脓毒症评分以及急性期蛋白α1-酸性糖蛋白、α1-抗胰蛋白酶、补体因子B和C3的血浆水平。初始脓毒症评分是生存的一个重要决定因素：幸存者的评分显著低于非幸存者。脓毒症评分高于20分的患者中只有8%存活。在严重脓毒症发作时，非幸存者的所有四种急性期蛋白的血浆水平均显著较低。存活和非存活患者血浆中C3a水平的显著升高表明，所有严重脓毒症患者的补体成分均有明显消耗。我们建立了一个预测生存的线性方程：生存脓毒症指数（SIS）% = 121 + 0.26（补体因子B）+ 0.36（α1-酸性糖蛋白）- 6（脓毒症评分）。根据我们的分析，在严重脓毒症发作时，SIS为50%或更高可正确预测88%的幸存者，而SIS低于50%可在临床结果出现前几天正确预测86%的非幸存者。
