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一种通过整合六个基于微流控的中性粒细胞趋化迁移参数创建的脓毒症患者新的预后评估指标。

A novel prognosis evaluation indicator of patients with sepsis created by integrating six microfluidic-based neutrophil chemotactic migration parameters.

机构信息

University of Science and Technology of China, Hefei, 230026, China; Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, 230031, China.

The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.

出版信息

Talanta. 2025 Jan 1;281:126801. doi: 10.1016/j.talanta.2024.126801. Epub 2024 Sep 3.

Abstract

Impaired neutrophil migration in sepsis is associated with a poor prognosis. The potential of utilizing neutrophil chemotaxis to assess immune function, disease severity, and patient prognosis in sepsis remains underexplored. This study employed an innovative approach by integrating a multi-tip pipette with a Six-Unit microfluidic chip (SU-chip) to establish gradients in six microchannels, thereby analyzing neutrophil chemotaxis in sepsis patients. We compared chemotactic parameters between healthy controls (N = 20) and sepsis patients (N = 25), observing significant differences in gradient perception time (GP), migration distance (MD), peak velocity (V), chemotactic index (CI), reverse migration rate (RM), and stop migration number (SM). A novel composite indicator, the Sepsis Neutrophil Migration Evaluation (SNME) index, was developed by integrating these six chemotactic migration parameters. The SNME index and individual chemotaxis parameters showed significant correlations with the Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACHE II) score, hypersensitivity C-reactive protein (hs-CRP), and heparin-binding protein (HBP). Moreover, the SNME index demonstrated potential for monitoring sepsis progression, with ROC analysis confirming its predictive accuracy (area under the curve [AUC] = 0.895, cutoff value = 31.5, specificity = 86.73 %, sensitivity = 86.71 %), outperforming individual neutrophil chemotactic parameters. In conclusion, the SNME index represents a promising new tool for adjunctive diagnosis and prognosis assessment in patients with sepsis.

摘要

中性粒细胞迁移功能障碍与脓毒症预后不良有关。利用中性粒细胞趋化作用评估脓毒症患者免疫功能、疾病严重程度和预后的潜力尚未得到充分探索。本研究采用一种创新方法,将多尖端移液器与六单元微流控芯片(SU-chip)结合,在六个微通道中建立梯度,从而分析脓毒症患者的中性粒细胞趋化性。我们比较了健康对照组(N=20)和脓毒症患者组(N=25)的趋化参数,观察到梯度感知时间(GP)、迁移距离(MD)、峰值速度(V)、趋化指数(CI)、反向迁移率(RM)和停止迁移数(SM)存在显著差异。通过整合这六个趋化迁移参数,我们开发了一种新的复合指标——脓毒症中性粒细胞迁移评估(SNME)指数。SNME 指数和个体趋化参数与序贯器官衰竭评估(SOFA)评分、急性生理学和慢性健康评估(APACHE II)评分、超敏 C 反应蛋白(hs-CRP)和肝素结合蛋白(HBP)显著相关。此外,SNME 指数具有监测脓毒症进展的潜力,ROC 分析证实其预测准确性(曲线下面积 [AUC] = 0.895,临界值 = 31.5,特异性 = 86.73%,敏感性 = 86.71%),优于个体中性粒细胞趋化参数。总之,SNME 指数代表了一种有前途的新工具,可用于辅助诊断和评估脓毒症患者的预后。

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