危重病患者循环内皮细胞数和血脂水平的变化

Relationship between the number of circulating endothelial cells and blood lipid level in critically ill patients and their clinical significance

目的探讨危重病患者循环内皮细胞(CEC)数与血脂水平的变化及临床意义。方法用Percoll等密度梯度离心法分离35例危重病患者CEC及常规进行血脂测定,并与20例健康体检者进行比较,进行相关性分析。同时用急性生理学与慢性健康状况评估系统Ⅱ(APACHEⅡ)对危重病患者的严重程度进行评估,并与CEC数与血脂水平进行相关性分析。结果危重病组与正常对照组比较,CEC数明显增加,差异有显著性(P<0.05)。危重病组TG、TC、LDL-C明显低于对照组,差异有显著性(P<0.05)。CEC数与TG、TC、LDL-C水平呈负相关(分别为TG:r=-0.396,P<0.05;TC:r=-0.672,P<0.05;LDL-C:r=-0.486,P<0.05)。危重病组APACHEⅡ评分与CEC数呈正相关(r=0.436,P<0.05),与TG、TC、LDL-C水平呈负相关(分别为TG:r=-0.372,P<0.05;TC:r=-0.425,P<0.05;LDL-C:r=-0.477,P<0.05)。结论危重病患者血管内皮细胞受损,血脂水平下降,血脂值结合循环内皮细胞数可作为评估危重病严重程度的参考指标。

Objective To study the changes of the number of circulating endothelial cells （CEC） and blood lipid level in critically ill patients and their clinical significance. Methods The CECs were separated by using isopyknic centrifugation method and blood lipid level was determined in 35 critically ill patients and 20 healthy controls. CEC number and blood lipid level were compared between the two groups. And the correlation of CEC number and blood lipid level was analyzed. Clinical data from the critically ill patients was evaluated with acute physiology and chronic health evaluation Ⅱ; the correlation analysis of APACHE Ⅱ score, CEC number and blood lipid level was made. Results CEC number in the critically ill patients was significantly higher than that in healthy controls（P〈0.05）. TG, TC and LDL-C were significantly lower than those in healthy controls（P〈0.05）. There was a significant negative correlation between CEC and TG, TC and LDL-C. And there was a significant positive correlation between APACHE Ⅱ score and CEC number, and a significant negative correlation between APACHE Ⅱ score and TG, TC and LDL-C level in the critically ill patients. Conclusion Vascular endothelial cell damage occurs in critically ill patients and blood lipid level decreases. The parameters may show the severity of the disease in critically ill patients.