脓毒症患者血清假血友病因子血管性血友病因子裂解酶水平变化的临床意义

摘要

Objective To investigate the clinical significance of Von Willebrand Factors (VWF) and a distintegrin-like and metalloprotease with thrombospondin type 1 domain 13 (ADAMTS13) level in the serum of patients with sepsis.Methods Serum and clinical data of 66 septic patients were collected,and the serum of 20 volunteers were chosen at random.ELISA was performed to detect VWF and ADAMTS13 level in serum.Septic patients were randomly divided into sepsis group,severe sepsis group and multiple organ dysfunction syndrome (MODS) group.Comparedwith control group,the relationship of VWF,ADAMTS13 level change in serum with sepsis severity degree was observed.Results There was a statistically significant difference in VWF,ADAMTS13 level between control group and each group (sepsis group,severe sepsis group,MODS group).The serum VWF level was significantly higher in sepsis group and severe sepsis group than in control group,and was significantly higher in MODS group than in sepsis group and severe sepsis group.Serum ADAMTS13 level was significantly lower in each model group than in control group.Conclusion At the early stage of sepsis,VWF and ADAMTS13 has participated in.The change of serum VWF level is more sensitive than ADAMTS13 in predicting the outcome of sepsis.%目的 探讨脓毒症患者血清假血友病因子(VWF)、血管性血友病因子裂解酶(ADAMTS13)水平变化的临床意义.方法 收集66例脓毒症患者的血清及临床资料,并从正常人群中随机抽取20例志愿者的血清,采用ELISA法分别定量检测血清VWF和ADAMTS13水平.把脓毒症患者分为脓毒症(sepsis,S)组、严重脓毒症(severe sepsis,SS)组及多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)组,与正常对照(C)组比较,观察血清VWF、ADAMTS13水平变化与脓毒症严重程度之间的关系.结果 S组、SS组和MODS组血清VWF、ADAMTS13水平与C组比较差异有统计学意义(P＜0.05).S组和SS组血清VWF水平显著高于C组,MODS组VWF水平较S组和SS组显著增高,ADAMTS13水平在脓毒症各组均显著低于C组.结论 VWF、ADAMTS13从脓毒症发病早期即开始参与,患者血清VWF水平的变化在预测脓毒症预后较ADAMTS13更敏感.