Zhuo Mengke, Fu Sifeng, Chi Yawen, Li Xinghua, Li Sirui, Ma Xiaochun, Li Xu
Department of Critical Care Medicine, The First Affiliated Hospital of China Medical University, North Nanjing Street 155, Shenyang, Liaoning Province, 110001, China.
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Diseases, Guangzhou, 510120, China.
Ann Intensive Care. 2024 Nov 10;14(1):169. doi: 10.1186/s13613-024-01393-0.
The impairment of endothelial function represents a key pathophysiological mechanism in the development of sepsis. This research aimed to evaluate the prognostic significance of angiopoietin-2 (Ang-2), an endothelial biomarker, in predicting mortality in sepsis patients.
Chinese and English studies were systematically retrieved in PubMed, Cochrane Library, Embase, WanFang, CNKI, CQVIP, and CBM databases up to July 16, 2023. We conducted a study selection established upon predefined inclusion and exclusion criteria and used the Newcastle-Ottawa scale (NOS) to assess its quality. We extracted available data from the included studies for data analysis.
The final inclusion comprised 33 studies with 4703 participants. According to the NOS, one study was of medium quality, while the rest were of high quality. In comparison to survivors, the levels of Ang-2 in non-survivors were markedly elevated [standardized mean difference (SMD) = 1.08, 95% confidence intervals (CI) 0.68-1.49, P < 0.001], and the same results were also observed in the subgroup that met sepsis 3.0 diagnosis criteria (SMD = 0.63, 95% CI 0.11-1.14, P = 0.017). The results comparing Ang-2 levels between non-survivors and survivors were independent of duration of follow-up, sample sources, type of study, and region. Ang-2 was a risk factor for mortality [odds ratios (OR) = 1.16, 95% CI 1.09-1.23, P < 0.001]. Ang-2 was demonstrated to be able to predict mortality in septic adult patients [area under the curve (AUC) = 0.76, 95% CI 0.70-0.82, P < 0.001].
Ang-2 level was positively correlated with risk of death in sepsis patients. Ang-2 might be a useful and valuable biomarker for predicting mortality in septic adult patients.
内皮功能障碍是脓毒症发生发展的关键病理生理机制。本研究旨在评估内皮生物标志物血管生成素-2（Ang-2）在预测脓毒症患者死亡率方面的预后意义。
截至2023年7月16日，在PubMed、Cochrane图书馆、Embase、万方、知网、维普和中国生物医学文献数据库中系统检索中英文研究。我们根据预先定义的纳入和排除标准进行研究筛选，并使用纽卡斯尔-渥太华量表（NOS）评估其质量。我们从纳入的研究中提取可用数据进行数据分析。
最终纳入33项研究，共4703名参与者。根据NOS，1项研究质量中等，其余研究质量高。与幸存者相比，非幸存者的Ang-2水平显著升高[标准化均数差（SMD）=1.08，95%置信区间（CI）0.68 - 1.49，P<0.001]，在符合脓毒症3.0诊断标准的亚组中也观察到相同结果（SMD = 0.63，95% CI 0.11 - 1.14，P = 0.017）。非幸存者与幸存者之间Ang-2水平比较的结果不受随访时间、样本来源、研究类型和地区的影响。Ang-2是死亡的危险因素[比值比（OR）=1.16，95% CI 1.09 - 1.23，P<0.001]。Ang-2被证明能够预测成年脓毒症患者的死亡率[曲线下面积（AUC）=0.76，95% CI 0.70 - 0.82，P<0.001]。
Ang-2水平与脓毒症患者的死亡风险呈正相关。Ang-2可能是预测成年脓毒症患者死亡率的有用且有价值的生物标志物。
