脓毒症患者血浆趋化因子受体4水平及临床意义

The Clinical Significance of CXC Chemokine Receptor 4 Expression in Patients with Sepsis

目的探讨脓毒症患者血浆趋化因子受体4(CXCR4)水平及临床意义。方法选取脓毒症患者108例,根据病情严重程度分组:脓毒症组29例、严重脓毒症组47例和脓毒性休克组32例。选取同期本院体检健康者86例作为健康对照组。采用双抗体夹心酶联免疫吸附实验(ELISA)检测各组血浆中CXCR4水平,同时检测血白细胞计数(WBC)、降钙素原(PCT)、血气分析乳酸(Lac)水平,并计算患者入院24h急性生理和慢性健康状况评分II(APACHE II)。结果脓毒症患者血浆中的CXCR4表达水平高于健康对照组,并且随病情加重逐步增高(P<0.05)。三组脓毒症患者CXCR4及WBC、PCT、Lac等均高于健康对照组(P均<0.05);严重脓毒症组的WBC、Lac、APACHE II评分,脓毒症休克组的CXCR4、WBC、PCT、Lac及APACHE II评分均高于脓毒症组(P<0.05);脓毒性休克组除CXCR4及PCT水平高于严重脓毒症组外(P<0.05),其余指标在两组间比较差异无统计学意义(P>0.05)。脓毒症死亡组血浆CXCR4及PCT水平均高于存活组(P<0.05)。结论血浆CXCR4水平对脓毒症患者病情及预后评估具有一定的临床应用价值。

Objective To evaluate the expression pattern of CXC chemokine receptor 4(CXCR4)and to analyze its clinical significance in patients with sepsis. Methods A total of 108 sepsis patients and 86 healthy subjects were selected and the sepsis patients were divided into three groups according to international guide for sepsis:sepsis group(29 cases),severe sepsis group(47 cases) and septic shock group(32 cases). By using enzyme-linked immuno sorbent assay(ELISA)analysis,the expression of CXCR4 levels were quantitied in the serum of all groups. Furthermore,the value of white blood cell count(WBC),blood procalcitonin(PCT),plasma lactic acid(Lac)and acute physiology and chronic health evaluation II(APACHE II)score were also determined.Results The expression pattern of CXCR4 in sepsis group,severe sepsis group and septic shock group were significantly higher than those of healthy group. The increased expression of CXCR4 were significantly correlated with disease severity(P<0.05). The value of white blood cell count(WBC),blood procalcitonin(PCT),plasma lactic acid(Lac)and APACHE II score in severe sepsis group and septic shock group were significantly higher than those of healthy group(P<0.05). The level of CXCR4 and PCT were significantly higher in septic shock group than that in severe sepsis group(P<0.05),there were no significant differences in WBC,PCT,Lac and APACHE II score between septic shock group and severe sepsis group(P>0.05). In addition,the CXCR4 expression levels was obviously higher in death group than that in survival group(P<0.05). Conclusion The expression level of CXCR4 were closely related to the sepsis stage,it may be a clinical useful prognostic molecular biomarker to identify septic shock patients with poor prognosis.