脓毒症患者早期血浆Apelin水平变化对临床预后的影响

摘要

Objective To observe the levels of serum Apelin in patients with sepsis .Methods A prospective and observational study was underwent in patients with sepsis who admitted to intensive care unit(ICU). Blood samples were collected daily and APACHEⅡscores were calculated daily. The concentration of serum Apelin was measured by enzyme-linked immunosorbent assay(ELISA). According to the data of serum Apelin measured at every stage,48 patients were divided into three groups:sepsis group, severe sepsis group and septic shock group, and 20 healthy controlled people were detected and compared. Results The levels of serum Apelin in sepsis group, severe sepsis group and septic shock group were significantly higher than those in control group,the difference was significant(P＜0.01). The level of serum Apelin was significantly higher in septic shock group when compared with sepsis group and severe sepsis group,the difference was significant(P＜0.05). The severity of patients rose gradually when the levels of serum Apelin increased. The levels of serum Apelin did not contribute to APACHEⅡscores. Conclusions The level of serum Apelin in patients changs with sepsis serious degree, Which may provide a clue of diagnosing sepsis.%目的 观察脓毒症患者早期血浆Apelin水平的变化规律,探讨其对发生脓毒症性休克的预测价值.方法 采用酶联免疫分析法测定48例脓毒症患者血浆Apelin水平,并进行APACHEⅡ评分,分别于脓毒症、严重脓毒症和脓毒症性休克后第1天检测血浆Apelin水平;另择20例健康志愿者作为对照组,比较各组血浆Apelin水平.结果 与对照组相比,脓毒症组、严重脓毒症组、脓毒症性休克组血浆Apelin水平明显升高(P均＜0.01);且脓毒症性休克组明显高于脓毒症组和重度脓毒症组.脓毒症组、严重脓毒症组、脓毒症性休克组的APACHEⅡ评分呈逐渐升高趋势.相关性分析显示,脓毒症患者早期血浆Apelin水平与APACHEⅡ评分无明显相关性.结论 脓毒症患者早期即出现血浆Apelin水平变化,其水平反映脓毒症患者病情严重程度,血浆Apelin水平可作为预测脓毒症性休克发生的指标.