脓毒症患者中血清程序化细胞死亡因子5水平的変化

摘要

Objective:To investigate the changes of serum programmed cell death 5 (PDCD5) levels in patients with critical illnesses including systemic inflammatory response syndrome ( SIRS, except sepsis) , sepsis (except severe sepsis) and severe sepsis. Methods: A total of 78 patients were enrolled in this study, of whom, 28 were with SIRS, 23 with sepsis and 27 with severe sepsis. Twenty-two healthy individuals were included as controls. The levels of serum PDCD5 were evaluated by enzyme-linked immune sorbent assay. And the correlation analyses were made in the levels of sreum PDCD5 and acute physiology and chronic health evaluation Ⅱ ( APACHE Ⅱ ) , high-sensitivity C-reactive protein ( hs-CRP) , white blood cell count, neutrophil count and age factors. Results: Serum PDCD5 levels in the SIRS, sepsis and severe sepsis groups were ( 19. 07 ±8. 91) , (29. 03 ± 13. 27) and (42. 83 ± 17. 32) μg/L respectively, which were significantly higher than that in the healthy control group (0.32 ±0.02) μg/L. Serum PDCD5 levels in SIRS, sepsis and severe sepsis groups were gradually increased with significant difference at any in-between comparison (P <0. 05). Moreover, serum PDCD5 levels were positively correlated with the acute physiology and chronic health evaluation Ⅱ ( APACHE Ⅱ ) score (r =0.572, P<0. 05). Conclusion: The serum PDCD5 levels in the critically ill patients with sepsis were progressively increased with the worsened condition. The up-regulated expression of PDCD5 may play an important role in the development and progression of sepsis.%目的:探讨血清程序化细胞死亡因子5(programmed cell death 5 protein,PDCD5)水平在全身炎症反应综合征(systemic inflammatory response syndrome,SIRS)、脓毒症及重症脓毒症患者中的变化.方法:78例患者纳入本研究,其中SIRS(脓毒症除外)患者28例、脓毒症(重症脓毒症除外)患者23例、重症脓毒症患者27例,并选取健康对照22例,分别收集其静脉血清,采用酶联免疫吸附法检测PDCD5水平,比较PDCD5水平的差异.采用Spearman 相关分析评价血清PDCD5水平与急性生理和慢性健康状况评分Ⅱ(acute physiology and chronic health evaluation Ⅱ,APACHEⅡ)积分、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、白细胞计数、中性粒细胞计数和年龄等因素的相关性.结果:在SIRS组、脓毒症组及重症脓毒症组中,血清PDCD5水平分别为(19.07 ±8.91)、(29.03±13.27)及(42.83±17.32)μg/L,显著高于健康对照组的(0.32±0.02) μg/L(P＜0.05)；血清PDCD5水平在SIRS组、脓毒症组及重症脓毒症组中呈现依次升高的变化规律,组间差异具有统计学意义(P＜0.05).此外,血清PDCD5水平与APACHEⅡ积分呈正相关(r=0.572,P＜0.05).结论:脓毒症患者血清PDCD5水平随着病情加重呈升高趋势,提示PDCD5表达上调在脓毒症发生、发展中可能起到一定作用.