血清血管内皮钙黏蛋白和脓毒性休克的相关性研究

Correlation between serum vascular endothelial cadherin and septic shock

目的探究血清血管内皮钙黏蛋白(VE-Cad)与脓毒性休克患者病情严重程度以及生存状况的相关性.方法选取2016年1月-2018年12月西藏自治区人民政府驻成都办事处医院接受治疗的142例脓毒性休克患者为研究对象,其中生存组93例,病死组49例.比较两组患者VE-Cad、血管内皮生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及C-反应蛋白(CRP)水平;比较两组患者急性生理与慢性健康评分II(A-PACHE II)和序贯性器官衰竭评估(SOFA);比较两组患者血管外肺水指数、乳酸含量、机械通气时间、重症监护病房(ICU)住院天数.结果生存组患者VE-Cad、VEGF、TNF-α、IL-6以及CRP水平均低于病死组患者,差异有统计学意义(P<0.05).生存组患者APACHE II、SOFA评分低于病死组患者,差异有统计学意义(P<0.05).生存组患者血管外肺水指数、乳酸含量、机械通气时间以及ICU住院天数均少于病死组患者,差异有统计学意义(P<0.05).结论血清VE-Cad水平与脓毒性休克患者病情严重程度及预后有明显相关性,血清VE-Cad水平越高,患者病情越严重,预后状况越差,临床可加强对此指标的监控.

OBJECTIVE To explore the correlation between serum vascular endothelial cadherin(VE-Cad)and severity of septic shock as well as survival status of the patients.METHODS A total of 142patients with septic shock who were treated in Tibet Branch of West China Hospital of Sichuan University from Jan 2016to Dec 2018were recruited as the study objects and were divided into the survival group with 93cases and the death group with 49 cases.The levels of VE-Cad,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and C-reactive protein(CRP)were compared between the two groups of patients;the Acute Physiology and Chronic Health Score II(APACHE II)and Sequential Organ Failure Assessment(SOFA)were compared between the two groups of patients;the extravascular pulmonary water index,lactate content,mechanical ventilation duration and length of ICU stay were compared between the two groups of patients.RESULTS The levels of VE-Cad,VEGF,TNF-α,IL-6and CRP of the survival group were significantiy lower than those of the death group(P<0.05).The scores of APACHE II and SOFA of the survival group were significantiy lower than those of the death group(P<0.05).The extravascular pulmonary water index,lactate content,mechanical ventilation duration and length of ICU stay of the survival group were significantiy less than those of the death group(P<0.05).CONCLUSION There is remarkable correlation between the serum VE-Cad level and the severity of illness condition as well as the prognosis of the patients with septic shock;the more severer the illness condition,the poorer the prognosis is.It is necessary for the hospital to strengthen the monitoring of the index.