脂联素和Hs—CRP在全身炎症反应综合征患者中的作用

Effects of early prewarning of adiponectin and hs-CRP on the patients with systemic inflammatory response syndrome

目的探讨脂联素与高敏-C反应蛋白（hs-CRP）对全身炎症反应综合征患者病情和预后的判断作用。方法将100例人住急诊ICU的SIRS患者分为多器官功能障碍综合征组（MODS组）和非MODS组，存活组和死亡组；选择健康体检者40例作为对照组采用酶联免疫（ELISA）法检测血清脂联素含量，采用免疫比浊法对血清Hs—CRP进行测定；分别检测血清脂联素和Hs—CRP浓度，并进行APACHEⅡ评分。结果SIRS患者Hs-CRP浓度明显高于对照组（P〈0．01）；MODS组和死亡组Hs—CRP浓度和APACHEⅡ评分分别明显高于非MODS组和存活组（P〈0．01）；SIRS患者脂联素浓度明显低于对照组（P〈0．01）；MODS组和死亡组脂联素浓度明显低于非MODS组和存活组（P〈0．01）SIRS患者脂联素和Hs．CRP、APACHEll评分呈负相关（r=-0．76，-0．71，P值均〈0．01），SIRS患者Hs-CRP浓度与APACHEⅡ评分呈正相关（r=0．77，P〈0．01）。结论在SIRS患者中早期检测血清脂联素和Hs—CRP浓度对患者病情和预后有判断作用。

Objective To observe the changes of adiponectin and high-sensitivity C-reative protein （Hs-CRP） in the patients with systemic inflammatory response syndrome（SIRS） and to study the roles of adiponectin and Hs-CRP inevaluating the state of illness and the outcome. Methods 200 patients with SIRS in the intensive care unit（ICU） were divided into multiple organ dysfunction syndrome（MODS） group and non-MODS group according to the MODS diagnostic criterion, and were followed up for 28 days and then assigned to survival group and non-survival group, respectively; 40 healthy people were in the control group. The concentrations of adiponcctin was measured by enzyme-linked immunosorbent assay （ ELISA）, and Hs-CRP was determined by rate nephelometry immunoassay, and APACHE Ⅱ scores were calculated. Results The concentrations of hs-CRP in the patients with SIRS were higher than those in control group（P 〈0. 02 ）. The concentrations of hs-CRP and A- PACHE Ⅱ scores in the MODS group and the non-survival group were higher than those in non-MODS group and the survival group（ all P 〈 0. 01 ）. The concentrations of adiponectin in the patients with SIRS were lowerer than those in control group（ P 〈 0. 01 ）. The concentrations of adiponectin in the MODS group and the non-survival group were lowerr than those in non-MODS group and the survival group（ all P 〈 0. 01 ）. There was negatively correlation between the concentrations of adiponectin and the concentrations of hs-CRP（ r = -0. 76, P 〈 0. 01 ）. There was negatively correlation between adiponectin and APACHE Ⅱ scores （ r = -0.72, P 〈 0. 02 ）. There was positive correlation between the concentrations of hs-CRP and APACHE Ⅱ scores （ r = 0. 77, P 〈 0. 01 ）. Conclusion Early test of the concentrations of adiponcctin and hs-CRP in patients with SIRS can be used to evaluate the state of illness and prognosis.