Burgmann H, Winkler S, Locker G J, Presterl E, Laczika K, Staudinger T, Knapp S, Thalhammer F, Wenisch C, Zedwitz-Liebenstein K, Frass M, Graninger W
Department of Internal Medicine 1, University of Vienna Medical School, Austria.
Clin Immunol Immunopathol. 1996 Sep;80(3 Pt 1):307-10. doi: 10.1006/clin.1996.0128.
Increased serum sCD14 concentrations are associated with poor outcome in Gram-negative sepsis and trauma patients. In the present study serum sCD14 concentrations were measured in patients with Gram-positive sepsis and compared with Gram-negative septic and nonseptic intensive care unit patients. Furthermore, serum sCD14 concentration was correlated with patient's outcome. Serum samples of 28 Gram-positive (8 nonsurvivors/20 survivors) and 10 Gram-negative bacteriemic patients (3 nonsurvivors/7 survivors) were obtained at the day they met the sepsis criteria defined by Bone et al. (Day 0) and at Days 4 and 7 and compared with 10 nonseptic ICU patients and 10 healthy volunteers. Serum concentrations of sCD14 were measured by ELISA. Significantly higher sCD14 serum concentrations were found on Days 4 and 7 in Gram-positive nonsurvivors than in Gram-positive survivors (Day 4: 5.85 +/- 0.48 vs 4.07 +/- 0.43 microgram/ml, P < 0.05; Day 7: 6.12 +/- 0.46 vs 3.53 +/- 0.33 microgram/ml, P < 0.01). In addition, sCD14 concentrations of Gram-positive nonsurvivors were significantly higher than those of nonseptic ICU patients and healthy volunteers at any time of observation. However, no significant difference was calculated between Gram-positive and Gram-negative patients. Summarizing our results, the serum level of sCD14 could be proven to be a good prognostic marker in the course of Gram-positive sepsis. Increased levels are associated with a high mortality.
血清可溶性CD14（sCD14）浓度升高与革兰氏阴性脓毒症及创伤患者的不良预后相关。在本研究中，对革兰氏阳性脓毒症患者的血清sCD14浓度进行了测定，并与革兰氏阴性脓毒症及非脓毒症重症监护病房患者进行了比较。此外，血清sCD14浓度与患者的预后相关。在28例革兰氏阳性（8例非幸存者/20例幸存者）和10例革兰氏阴性菌血症患者（3例非幸存者/7例幸存者）符合Bone等人定义的脓毒症标准当天（第0天）、第4天和第7天采集血清样本，并与10例非脓毒症重症监护病房患者和10例健康志愿者的样本进行比较。采用酶联免疫吸附测定法（ELISA）检测血清sCD14浓度。革兰氏阳性非幸存者在第4天和第7天的sCD14血清浓度显著高于革兰氏阳性幸存者（第4天：5.85±0.48 vs 4.07±0.43微克/毫升，P<0.05；第7天：6.12±0.46 vs 3.53±0.33微克/毫升，P<0.01）。此外，在任何观察时间，革兰氏阳性非幸存者的sCD14浓度均显著高于非脓毒症重症监护病房患者和健康志愿者。然而，革兰氏阳性和革兰氏阴性患者之间未计算出显著差异。总结我们的结果，血清sCD14水平可被证明是革兰氏阳性脓毒症病程中的一个良好预后标志物。水平升高与高死亡率相关。
