脓毒症患者血浆Apelin的变化及临床意义

The changes and the clinical significance of plasma Apelin in elderly patients with sepsis

目的了解脓毒症患者Apelin水平变化及临床意义，探讨其变化及对脓毒症患者预后评估价值。方法对26例脓毒症患者，平均年龄（72．9±9．7）岁和30例健康对照者采用酶联免疫吸附法（ELASE）测定血Apelin-12含量，体质指数（BMI）、C反应蛋白（CRP）等，在亚组分析中将脓毒症患者分成存活组（18例）和死亡组（8例），以急性生理功能和慢性健康状况评分系统Ⅱ（APACHEII）分值将患者分为≤20分组（n=14）和〉20分组（n=12）比较各组指标的差异。结果脓毒症患者血Apelin水平（0．38±0．15）ng／L高于对照组（0．19±0．12）ng／L（t=2．011，P〈0．03）；脓毒症患者存活组与死亡组的血浆Apelin比较，死亡组（O．49±0．32）ng／L高于存活组（O．21±0．29）ng／I。（t=2．094，P=0．04）；脓毒症患者APACHE1／评分越高，血浆Apelin越高，差异均有统计学意义（P〈0．05）。多因素回归分析示Apelin的OR值：4．162，95％CI：1．115～15．535（P〈0．05）。结论脓毒症患者血Apelin增高反映脓毒症患者病情的危重程度，是脓毒症患者预后的死亡危险因素，对判断预后有参考价值。

Objective To investigate the clinical characteristic and the predicting value of plasma Apelin in elderly patients with sepsis. Methods A retrospective analysis was conducted in 26 sepsis patients aged （72.9 ± 9.7） years in average and 30 healthy controls. Serum Apelin level was measured by ELISA. Body mass index （BMI） and C-reaction protein （CRP） were detected. Patients were divided into survival group （n= 18） and death group （n=8） .According to acute physiology and chronic health evaluation （APACHE） Ⅱ , patients were divided into subgroup A （n= 14, APACHE Ⅱ score20） and subgroup B （n= 12, APACHE Ⅱ score〉20）. Results The Apelin concentration was higher in sepsis patients than in healthy controls [（0.38±0.15）ng/Lvs. （0.19±0.12）ng/L, t= 2. 011, P〈0. 05]. The Apelin concentration was lower in survival group than in death group[（0. 21±0.29）ng/L vs. （0.49 ± 0.32） ng/I., t = 2. 094, P〈0.05]. The Apelin level was increased with APACHE Ⅱ scores increment in sepsis patients （P〈0.05）. Multivariable logistic analysis showed that when taking survival/death as the dependent variable and Apelin as the independent variable, the OR value was 4. 162 with 95% CI= 1. 115-15. 535（P〈0.05）. Conclusions Increased serum Apelin level reflects the severity of illness in patients with sepsis, which is a risk factor for death in prognosis of