文章摘要

呼吸机相关性肺炎患者血清内皮细胞特异性分子-1浓度及临床价值

作者: 1汪 霞, 1徐 芳
1 华中科技大学同济医学院附属武汉中心医院肾内科,武汉 430014
通讯: 徐 芳 Email: xufang2223@126.com
DOI: 10.3978/j.issn.2095-6959.2020.01.007

摘要

目的:探讨呼吸机相关性肺炎(ventilator-associated pneumonia,VAP)患者血清内皮细胞特异性分子-1(Endocan)的浓度变化及临床价值。方法:纳入2018年1月到2019年1月华中科技大学同济医学院附属武汉中心医院综合ICU机械通气患者52例,其中最终诊断为VAP患者32例(VAP组),无VAP患者20例(无VAP组),选取同期年龄和性别相匹配的20例健康志愿者为对照组。ELISA法检测3组血清Endocan浓度,比较3组Endocan浓度差异,分析最终临床结局与VAP患者疾病严重程度及血清Endocan浓度的关系,Spearman相关分析Endocan浓度与临床不良结局的预测评分APACHEII和CRIP的相关性。结果:VAP组患者第1天血清Endocan浓度显著高于无VAP组[(11.37±2.53) ng/mL vs (5.07±3.50) ng/mL,P<0.01]和对照组[(11.37±2.53) ng/mL vs (4.12±2.9) ng/mL,P<0.01],无VAP组与对照组间血清Endocan浓度差异无统计学意义[(5.07±3.50) ng/mL vs (4.12±2.9) ng/mL,P>0.05]。非存活VAP患者第1天血清Endocan浓度显著高于存活者[(12.50±2.74) ng/mL vs (10.35±1.86) ng/mL,P<0.05],非存活者第7天血清Endocan浓度显著高于存活者[(24.33±7.14) vs (5.93±1.56) ng/mL,P<0.001]。存活者患者第7天血清Endocan浓度较第1天Endocan浓度显著下降[(10.35±1.86) ng/mL vs (5.93±1.56) ng/mL,P<0.05],非存活者第7天血清Endocan浓度显著增加[(12.50±2.74) ng/mL vs (24.33±7.14) ng/mL,P<0.001]。VAP组第1天血清Endocan浓度与APACHEII(r=0.549,P<0.001)和CRIP(r=0.599,P<0.001)存在显著正相关。结论:VAP患者血清Endocan浓度可能对VAP具有早期诊断和预后价值。
关键词: 呼吸机相关性肺炎;内皮细胞特异性分子-1;浓度;临床价值

Concentration and clinical value of Endocan in patients with ventilator-associated pneumonia

Authors: 1WANG Xia, 1XU Fang
1 Department of Nephrology, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China

CorrespondingAuthor:XU Fang Email: xufang2223@126.com

Abstract

Objective: To investigate the concentration and clinical value of endothelial cell-specific molecule-1 (Endocan) in patients with ventilator-associated pneumonia. Methods: Fifty-two patients with comprehensive ICU mechanical ventilation were enrolled in our hospital between January 2018 and January 2019. Among them, 32 patients with the final diagnosis of VAP (VAP group) and 20 patients without VAP (non-VAP group) were selected. The matched 20 healthy volunteers served as a control group. The serum Endocan concentration of the 3 groups was measured by ELISA. The difference of Endocan concentration in the 3 groups was compared, and the relationship between the final clinical outcome and the severity of VAP and the serum Endocan concentration was analyzed. Spearman correlation analysis was used to analyze the correlation between Endocan concentration and the predictive score of clinical adverse outcomes, APACHEII and CRIP. Results: Serum Endocan concentration was significantly higher on VAP patients on the first day than in non-VAP patients [(11.37±2.53) ng/mL vs (5.07±3.50 ng/mL, P<0.01]. Serum Endocan concentration was significantly higher than that of healthy controls [(11.37±2.53) ng/mL vs (4.12±2.9 ng/mL, P<0.01]. There was no significant difference in serum Endocan concentrations between patients without VAP and healthy controls [(5.07±3.50) ng/mL vs (4.12±2.9 ng/mL, P>0.05]. The Endocan concentration on the first day of non-survival VAP patients was significantly higher than that of survivors [(12.50±2.74) ng/mL vs (10.35±1.86) ng/mL, P<0.05]. The Endocan concentration of non-survivors on the 7th day was significantly higher than that of survivors [(24.33±7.14) ng/mL vs (5.93±1.56) ng/mL, P<0.001]. The Endocan concentration on day 7 of survivor patients was significantly lower than the Endocan concentration on day 1 [(10.35±1.86) ng/mL vs (5.93±1.56) ng/mL, P<0.05]. The serum Endocan concentration on the 7th day of non-survivors was significantly increased [(12.50±2.74) ng/mL vs (24.33±7.14) ng/mL, P<0.001]. There was a significant positive correlation between serum Endocan concentrations on the first day of VAP patients and predictive scores of clinical adverse outcomes APACHEII (r=0.549, P<0.001) and CRIP (r=0.599, P<0.001). Conclusion: The serum Endocan concentrations in VAP patients are significantly higher than those in non-VAP patients. The Endocan concentrations are significantly different between survivors and non-survivors, which may be potential biomarkers for VAP.
Keywords: ventilator-associated pneumonia; endothelial cell-specific molecule-1; concentration; clinical value