感染性休克患者治疗前后血清血管粘附蛋白-1及血浆多配体蛋白聚糖-1水平变化

Changes of serum levels of vascular adhesion protein-1 and plasma syndecan-1 before and after treatment in patients with septic shock

目的:研究感染性休克患者治疗前、后血清血管粘附蛋白-1(VAP-1)及血浆多配体蛋白聚糖-1(SDC-1)变化及其临床意义。方法:收集50例重症监护病房感染性休克患者为观察组,同期选择50例健康体检者为对照组,分析观察组治疗前、后第1、3、5天血VAP-1及SDC-1水平变化,同时比较观察组生存患者和死亡患者入院第1天时血清VAP-1及血浆SDC-1水平差异及APACHEⅡ评分。结果:与对照组比较,观察组患者治疗前及治疗后第1、3、5天血清VAP-1及血浆SDC-1水平明显升高(均P<0.05),观察组血清VAP-1及血浆SDC-1水平在治疗后第1、3天升高,治疗后第5天明显低于第3天(均P<0.05);观察组中35例生存患者在入院第1天血清VAP-1、血浆SDC-1水平及APACHEⅡ评分明显低于15例死亡患者(均P<0.05)。结论:早期联合检测血VAP-1及SDC-1水平变化有助于判断感染性休克患者病情严重程度及预后。

Objective： To investigate the changes of serum level of vascular adhesion protein-1（ VAP-1） and plasma level of syndecan-1（ SDC-1） before and after treatment in patients with severe septic shock and its clinical significance.Methods： Clinical data of 50 patients with septic shock in intensive care unit were collected for this study as the observation group,50 healthy screening adults as the control group. The serum level of VAP-1 and plasma SDC-1 level were compared before and after treatment on day 1,3 and 5. At the same time,the differences of serum level of VAP-1,plasma SDC-1 level and APACHE Ⅱ scores on admission were compared between survivors and non-survivors in the observation group（ all P〈0. 05）. Results： The serum level of VAP-1 and plasma SDC-1 level were significantly higher in observation group than those in the control group before treatment and after treatment on day 1,3 and 5（ all P〈0. 05）. In the observation group,the serum level of VAP-1 and plasma SDC-1 level were increased gradually after treatment in the 1st day and the 3rd day,and significantly lowered on day 5 compared to those on day 3（ all P〈0. 05）. The serum level of VAP-1,plasma SDC-1 level and APACHEⅡ scores in 35 survived patients were significantly lower than those of 15 dead patients（ all P〈0. 05）. Conclusion： Early combined detection of VAP-1 and SDC-1 in patients with severe septic shock could help to evaluate the severity of disease and prognosis.