多发伤合并脓毒症患者血浆s-CD62P水平与炎症因子、凝血指标的相关性研究

Correlation between plasma s-CD62P level and inflammatory factors, coagulation index in patients with multiple trauma and sepsis

目的探讨多发伤合并脓毒症患者血浆可溶性颗粒膜蛋白CD62P(s-CD62P)、炎症因子、凝血指标的表达特征,并分析三者的关系。方法选取2017年1月—2019年12月南通大学附属医院ICU收治的多发伤合并脓毒症患者102例为观察组,同期100例健康体检者为对照组。采集空腹静脉血,检测血浆s-CD62P,炎症因子[肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、降钙素(PCT)]及凝血指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血小板计数(PLT)D-二聚体(D-D)]水平。比较两组的血浆s-CD62P、炎症因子及凝血指标水平,采用Pearson相关性分析s-CD62P与炎症因子、凝血指标的关系。结果观察组的血浆s-CD62P水平为(223.05±69.14)ng/mL,对照组为(96.25±31.54)ng/mL。观察组的血浆s-CD62P水平高于对照组(P <0.05)。观察组的TNF-α、hs-CRP、PCT、IL-6、PT、APTT、D-D水平高于对照组(均P <0.05),PLT水平低于对照组(P <0.05)。Pearson相关性分析显示,s-CD62P与炎症因子TNF-α、hs-CRP、IL-6、PCT呈正相关(均P <0.05);s-CD62P与凝血指标PT、APTT、D-D呈正相关(均P <0.05),与PLT呈负相关(P <0.05)。TNF-α、hs-CRP、IL-6、PCT与PT、APTT、D-D呈正相关(均P <0.05),与PLT呈负相关(P <0.05)。结论多发伤合并脓毒症患者的血浆s-CD62P表达水平升高预示着内皮细胞损伤严重,其表达水平与炎症因子、凝血指标密切相关,其可能诱导了脓毒症炎症-凝血网络的形成。

Objective To investigate the expression of soluble granule membrane protein CD62P(sCD626P), inflammatory factor, and coagulation index in patients with multiple trauma and sepsis, and to analyze the relationship between them. Methods A total of 102 patients with multiple injuries complicated with sepsis and 100 healthy persons who received physical examination at the same time were selected as the observation group and the control group respectively. The levels of s-CD62P, inflammatory factors(TNF-α, hs-CRP, IL-6, PCT) and coagulation indexes(PT, APTT, PLT, D-D) were measured. The relationship between s-CD62P, inflammatory factors, and coagulation indexes was analyzed. Results The plasma s-CD62P level in the observation group was(223.05 ± 69.14) ng/mL, and that in the control group was(96.25 ± 31.54) ng/mL. The level of s-CD62P in the observation group was higher than that in the control group(P < 0.05). The levels of TNF-α, hs-CRP, PCT, IL-6, PT,APTT, and D-D water in the observation group were higher than those in the control group, and the levels of PLT were lower than those in the control group(P < 0.05). The correlation analysis showed that s-CD62P was positively correlated with TNF-α, hs-CRP, IL-6, and PCT(P < 0.05), while s-CD62P was positively correlated with Pt, APTT,and D-D(P < 0.05). TNF-α, hs-CRP, IL-6, and PCT were positively correlated with Pt, APTT, and D-D, and negatively correlated with PLT(P < 0.05). Conclusion The increased expression of s-CD62P in the plasma of patients with multiple trauma and sepsis indicates that the endothelial cells are seriously damaged. The expression of s-CD62P is closely related to inflammatory factors and coagulation indexes, which may induce the formation of inflammatory coagulation network in sepsis.