血清波形蛋白预测儿科严重脓毒症患者的死亡率：一项前瞻性观察性研究。

Serum vimentin predicts mortality in pediatric severe sepsis: A prospective observational study.

机构信息

Department of Critical Care Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Pediatric Critical Care, Shanghai Jiao Tong University, Shanghai, China; Institute of Pediatric Infection, Immunity and Critical Care Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Clinical Research Unit, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Int J Infect Dis. 2022 Aug;121:141-147. doi: 10.1016/j.ijid.2022.05.018. Epub 2022 May 11.

DOI:10.1016/j.ijid.2022.05.018

PMID:35568360

Abstract

OBJECTIVES

Vascular hyperpermeability by loss of endothelial barrier integrity is a hallmark of sepsis. Vimentin is involved in the regulation of the endothelial function and inflammatory response. However, the serum level of vimentin and its clinical relevance in pediatric severe sepsis (PSS) remain unknown.

METHODS

We conducted a prospective study of PSS cases who were admitted to the pediatric intensive care unit (PICU) from January 2018 to December 2020.

RESULTS

A total of 108 patients with PSS with a median age of 19.5 month were enrolled. The hospital mortality rate was 19.44% (21/108). Comparing with healthy controls, serum vimentin levels on PICU admission were significantly higher in patients with PSS (P < 0.001). The area under the ROC curve for vimentin to predict the hospital mortality was 0.712 (95% CI: 0.578-846) with a sensitivity of 71.43% and a specificity of 70.11%. Moreover, hospital mortality was significantly higher in patients with vimentin level over the cutoff value of 24.53 ng/ml than in patients with vimentin level below 24.53 ng/ml (P < 0.001).

CONCLUSIONS

Serum vimentin level as an indicator of endothelial injury is associated with the prognosis of PSS, and serum vimentin level ≥24.53 ng/ml on PICU admission predicts high risk for hospital mortality in PSS.

摘要

目的

内皮屏障完整性丧失导致的血管通透性增加是脓毒症的一个标志。波形蛋白参与内皮功能和炎症反应的调节。然而，血清波形蛋白水平及其在儿科严重脓毒症（PSS）中的临床相关性尚不清楚。

方法

我们进行了一项前瞻性研究，纳入了 2018 年 1 月至 2020 年 12 月期间入住儿科重症监护病房（PICU）的 PSS 患者。

结果

共纳入了 108 例年龄中位数为 19.5 个月的 PSS 患者。医院死亡率为 19.44%（21/108）。与健康对照组相比，PSS 患者 PICU 入院时的血清波形蛋白水平显著升高（P<0.001）。用于预测医院死亡率的血清波形蛋白的 ROC 曲线下面积为 0.712（95%CI：0.578-846），灵敏度为 71.43%，特异性为 70.11%。此外，血清波形蛋白水平超过 24.53ng/ml 截值的患者的医院死亡率显著高于血清波形蛋白水平低于 24.53ng/ml 的患者（P<0.001）。