脓毒症患者外周血α_1-酸性糖蛋白、凝血酶敏感蛋白1的表达水平及意义
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摘要
目的探讨脓毒症患者外周血α_1-酸性糖蛋白(AAP)、凝血酶敏感蛋白1(TSP1)表达水平及其临床意义。方法选取2017年6月～2018年6月在南宁市第一人民医院(以下简称"我院")进行健康体检者(30名)或者治疗患者90例。根据研究对象的健康状况分为正常组、非脓毒症的SIRS组(30例)、轻度脓毒症组(30例)、严重脓毒症组(30例),分别获取其清晨空腹血清。比较四组患者C反应蛋白(CRP)、降钙素原(PCT)、AAP、TSP1表达水平差异。结果非脓毒症的SIRS组、轻度脓毒症组、严重脓毒症组的CRP、PCT表达水平均显著高于正常组,差异有统计学意义(P <0.05)。轻度脓毒症组、严重脓毒症组的AAP、TSP1表达水平均显著高于正常组,差异有统计学意义(P <0.05)。轻度脓毒症组、严重脓毒症组的PCT、AAP、TSP1表达水平均高于非脓毒症的SIRS组,差异有统计学意义(P <0.05);严重脓毒症组的AAP表达水平高于轻度脓毒症组,差异有统计学意义(P <0.05)。结论PCT在诊断脓毒症中具有优势,AAP在脓毒症严重程度分级中具有优势,两者联合可以较好地判断非脓毒症的全身炎症反应综合征及脓毒症患者的严重程度,为临床早期治疗提供参考依据。
Objective To investigate the expression levels of α_1-acid glycoprotein(AAP) and thrombospondin 1(TSP1)in peripheral blood of patients with sepsis and its clinical significance. Methods From June 2017 to June 2018, 30 patients who underwent physical examination or 90 patients who were treated in the First People′s Hospital of Nanning( "our hospital" for short) were selected. According to the health status of the subjects, they were divided into normal group,non-sepsis SIRS group(30 cases), mild sepsis group(30 cases), severe sepsis group(30 cases), and their early morning fasting serum were obtained. The differences in expression levels of C-reactive protein(CRP), procalcitonin(PCT),AAP, and TSP1 were compared between the four groups. Results The expression levels of CRP and PCT in non-sepsis SIRS group, mild sepsis group and severe sepsis group were significantly higher than those in normal group(P < 0.05).The expression levels of AAP and TSP1 in mild sepsis group and severe sepsis group were significantly higher than those in normal group(P < 0.05). The expression levels of PCT, AAP and TSP1 in mild sepsis group and severe sepsis group were higher than those in non-sepsis SIRS group(P < 0.05), and the expression level of AAP in severe sepsis group was higher than that in mild sepsis group(P < 0.05). Conclusion PCT has advantages in the diagnosis of sepsis,AAP has advantages in the severity classification of sepsis. The combination of the two can better judge the severity of non-sepsis SIRS and sepsis patients, and provide reference for early clinical treatment.
Objective To investigate the expression levels of α_1-acid glycoprotein(AAP) and thrombospondin 1(TSP1)in peripheral blood of patients with sepsis and its clinical significance. Methods From June 2017 to June 2018, 30 patients who underwent physical examination or 90 patients who were treated in the First People′s Hospital of Nanning( "our hospital" for short) were selected. According to the health status of the subjects, they were divided into normal group,non-sepsis SIRS group(30 cases), mild sepsis group(30 cases), severe sepsis group(30 cases), and their early morning fasting serum were obtained. The differences in expression levels of C-reactive protein(CRP), procalcitonin(PCT),AAP, and TSP1 were compared between the four groups. Results The expression levels of CRP and PCT in non-sepsis SIRS group, mild sepsis group and severe sepsis group were significantly higher than those in normal group(P < 0.05).The expression levels of AAP and TSP1 in mild sepsis group and severe sepsis group were significantly higher than those in normal group(P < 0.05). The expression levels of PCT, AAP and TSP1 in mild sepsis group and severe sepsis group were higher than those in non-sepsis SIRS group(P < 0.05), and the expression level of AAP in severe sepsis group was higher than that in mild sepsis group(P < 0.05). Conclusion PCT has advantages in the diagnosis of sepsis,AAP has advantages in the severity classification of sepsis. The combination of the two can better judge the severity of non-sepsis SIRS and sepsis patients, and provide reference for early clinical treatment.
引文
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[9]刘华伟.急性细菌感染性疾病患者血清α1酸性糖蛋白水平测定的临床探讨[J].标记免疫分析与临床,2014,21(6):683-684.
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[14]刘洋,程庆砾,杨光.糖尿病肾病的蛋白质组学研究进展[J].中华肾病研究电子杂志,2018,7(4):182-185.
[15]辛向博.Myostatin基因对骨骼肌代谢机制影响的定量蛋白组学与磷酸化蛋白组学研究[D].天津:天津农学院,2018.
[16]姚振宇,武一,吉尚戎.CRP变构及其促炎机制研究进展[J].中国科学:生命科学,2017,47(8):863-870.
[17]Meisner M.Update on procalcitonin measurements[J].Ann Lab Med,2014,34(4):263-273.
[18]中国医药教育协会感染疾病专业委员会.感染相关生物标志物临床意义解读专家共识[J].中华结核和呼吸杂志,2017,40(4):243-257.
[19]Karon BS,Tolan NV,Wockenfus AM,et al.Evaluation of lactate,white blood cell count,neutrophil count,procalcitonin and immature granulocyte count as biomarkers for sepsis in emergency department patients[J].Clin Biochem,2017,50(16/17):956-958.
[20]Lin C,Lu J,Chen Y,et al.Diagnostic value of serum procalcitonin,lactate,and high-sensitivity C-reactive protein for predicting bacteremia in adult patients in the emergency department[J].Peer J,2017,5:e4094.
[21]贺政新,张丽娜,安黎云,等.α1-酸性糖蛋白、触珠蛋白、铜蓝蛋白评价炎性状态及与C反应蛋白相关性分析[J].中国实验诊断学,2015,19(3):468-470.
[22]Xiao K,Su L,Yan P,et al.α-1-Acid glycoprotein as a biomarker for the early diagnosis and monitoring the prognosis of sepsis[J].J Crit Care,2015,30(4):744-751.
[23]张东华,朱雪娟,邹霞,等.α1-酸性糖蛋白糖链检测对慢乙肝相关肝硬化的早期诊断及其临床应用[J].现代免疫学,2015,35(4):306-310.
[24]肖林,郭梅,胡加萍.尿和血清α1-酸性糖蛋白在早期糖尿病肾病诊断中的应用价值[J].海南医学,2016,27(24):3988-3990.
[2]田英.血必净注射液对全身炎症反应综合征患者体液免疫功能的调节作用[J].北方药学,2018,15(11):107-108.
[3]梁婉珍,骆连妹,陈振翅.降钙素原对ICU全身炎症反应综合征患者病因诊断及预后的价值[J].中国医药科学,2018,8(9):221-223.
[4]吴朝,董晓琴,赵鸿,等.脓毒症及脓毒性休克诊断与治疗研究进展[J].中华实用诊断与治疗杂志,2018,32(11):1126-1128.
[5]Lefeng Z,Xiaohong Z.Serum sTREM-1,PCT,CRP,Lac as biomarkers for death risk within 28 days in patients with severe sepsis[J].Open Life Sci,2018,13(1):42-47.
[6]Tang BM,Eslick GD,Craig JC,et al.Accuracy of procalcitonin for sepsis diagnosis in critically ill patients:systematic review and meta-analysis[J].Lancet Infect Dis,2007,7(3):210-217.
[7]Zhang J,She D,Feng D,et al.Dynanic changes of serum soluble triggering receptor expressed on myeloid cells-1(sTREM-1)reflect sepsis severity and can predict prognosis:a prospective study[J].BMC Infect Dis,2011,11:53.
[8]何嗪,黄国栋,武艳,等.双歧杆菌四联活菌片联合头孢克肟对细菌性肠炎患者C反应蛋白、铜蓝蛋白、触珠蛋白及α1酸性糖蛋白的影响研究[J].中国生化药物杂志,2015,35(9):109-111.
[9]刘华伟.急性细菌感染性疾病患者血清α1酸性糖蛋白水平测定的临床探讨[J].标记免疫分析与临床,2014,21(6):683-684.
[10]纪根宝,黄嵘,吴勇,等.基于Sepsis 3.0诊断标准之脓毒症患者死亡危险因素分析[J].广西医学,2018,40(19):2355-2357.
[11]Angus DC,Linde-Zwirble WT,Lidicker J,et al.Epidemiology of severe sepsis in the United States:analysis of incidence,outcome,and associated costs of care[J].Crit Care Med,2001,29(7):1303-1310.
[12]New hope for sepsis[J].Lancet 2012,379(9825):1462.
[13]李波,要志宏,胡舰,等.iTRAQ在蛋白质组学中的应用进展[J].食品安全导刊,2017(18):119.
[14]刘洋,程庆砾,杨光.糖尿病肾病的蛋白质组学研究进展[J].中华肾病研究电子杂志,2018,7(4):182-185.
[15]辛向博.Myostatin基因对骨骼肌代谢机制影响的定量蛋白组学与磷酸化蛋白组学研究[D].天津:天津农学院,2018.
[16]姚振宇,武一,吉尚戎.CRP变构及其促炎机制研究进展[J].中国科学:生命科学,2017,47(8):863-870.
[17]Meisner M.Update on procalcitonin measurements[J].Ann Lab Med,2014,34(4):263-273.
[18]中国医药教育协会感染疾病专业委员会.感染相关生物标志物临床意义解读专家共识[J].中华结核和呼吸杂志,2017,40(4):243-257.
[19]Karon BS,Tolan NV,Wockenfus AM,et al.Evaluation of lactate,white blood cell count,neutrophil count,procalcitonin and immature granulocyte count as biomarkers for sepsis in emergency department patients[J].Clin Biochem,2017,50(16/17):956-958.
[20]Lin C,Lu J,Chen Y,et al.Diagnostic value of serum procalcitonin,lactate,and high-sensitivity C-reactive protein for predicting bacteremia in adult patients in the emergency department[J].Peer J,2017,5:e4094.
[21]贺政新,张丽娜,安黎云,等.α1-酸性糖蛋白、触珠蛋白、铜蓝蛋白评价炎性状态及与C反应蛋白相关性分析[J].中国实验诊断学,2015,19(3):468-470.
[22]Xiao K,Su L,Yan P,et al.α-1-Acid glycoprotein as a biomarker for the early diagnosis and monitoring the prognosis of sepsis[J].J Crit Care,2015,30(4):744-751.
[23]张东华,朱雪娟,邹霞,等.α1-酸性糖蛋白糖链检测对慢乙肝相关肝硬化的早期诊断及其临床应用[J].现代免疫学,2015,35(4):306-310.
[24]肖林,郭梅,胡加萍.尿和血清α1-酸性糖蛋白在早期糖尿病肾病诊断中的应用价值[J].海南医学,2016,27(24):3988-3990.