高水平血清诱骗受体3预示脓毒症休克患者病情严重

High level of serum DCR3 can predict the severity of patients with sepsis/septic shock

目的:探讨诱骗受体3(DCR3)对严重脓毒症/脓毒症休克患者病情和预后的预测价值。方法:选取西安市中心医院ICU 2016年9月-2018年9月收治的严重脓毒症患者100例,按照是否发生感染性休克分为严重脓毒症组48例,脓毒症休克组52例,脓毒症休克组根据1个月生存情况又分为存活组36例和死亡组16例。同时选取50例同期健康体检者为对照组。采用酶联免疫法、化学发光法、IMMAGE800特种蛋白仪检测所有入选者治疗前、后不同时间血清DCR3、降钙素原(PCT)、C反应蛋白(CRP)水平。结果:治疗前,与对照组比较,严重脓毒症组和脓毒症休克组患者血清DCR3、PCT和CRP水平显著升高;且脓毒症休克组高于严重脓毒症组(P均<0.05)。治疗后1、3、7 d,与严重脓毒症组比较,脓毒症休克组患者血清DCR3、PCT和CRP水平较高(P均<0.05)。存活组患者治疗后第1、3、7 d血清DCR3、PCT和CRP水平显著低于死亡组(P均<0.05)。结论:与严重脓毒症患者比较,脓毒症休克患者DCR3、PCT、CRP水平显著升高,治疗过程中血清DCR3水平变化敏感,可能指导临床治疗。

Objective:To investigate the correlation between decoy receptor 3(DCR3)and severity of severe sepsis/septic shock patients and the predictive value of DCR3 in the disease prognosis.Methods:Totally,100 patients with severe sepsis were divided into severe sepsis group(48 cases)and septic shock group(52 cases)according to the severity of septic shock.According to the one-month survival,the septic shock group was divided into survival subgroup(36 cases)and death subgroup(16 cases).At the same time,50 cases of healthy control group were selected.The levels of serum DCR3,procalcitonin(PCT)and C-reactive protein(CRP)before and after treatment were detected by enzyme-linked immunosorbent assay(ELISA),chemiluminescence and IMMAGE 800 special protein analyzer.Results:Compared with the control group and severe sepsis group,the levels of serum DCR3,PCT and CRP in septic shock group increased significantly.Compared with severe sepsis group,serum DCR3,PCT and CRP levels in septic shock group increased significantly,and the differences were significant(P<0.05).After 1st,3rd and 7th day of treatment,the levels of serum DCR3,PCT and CRP in septic shock group were significantly higher than those in severe sepsis group,and the differences were significant(P<0.05).The levels of serum DCR3,PCT and CRP in survival subgroup were significantly lower than those in death subgroup on the 1st,3rd and 7th day after treatment,and the differences were significant(P<0.05).Conclusions:Compared with patients with severe sepsis,the levels of DCR3,PCT and CRP in patients with severe sepsis/septic shock are significantly increased,and the change of serum DCR3 level during treatment is sensitive,which may guide the clinical treatment.