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首页> 中文期刊> 《安徽医药》 >脓毒症患者血清VEGF-A与sFLT-1水平变化的临床意义

脓毒症患者血清VEGF-A与sFLT-1水平变化的临床意义

         
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摘要

Objective To invesligale the changes of serum VEGF-A, sFLT-1 levels and aclivily VEGF-A index ( VEGF-A/sFLT-1 ), and to analyze their clinical significance of evaluation and prognosis prediclion in sepsis palienls. Methods Fifly-nine sepsis palienls were sludied after admilled lo ihe I cu of Firsl Affiliated Hospilal of Anhui Medical Universily from March 2008 lo Augusl 2010, and 20 heallhy people were involved in conlrol group. The sepsis palienls were divided inlo ihe survival group and ihe dealh group further according lo the survival slalus al 28 days. Serum VEGF-A and sFLT-1 levels were assayed by ELISA in all palienls, furthermore, aclivily indices of VEGF-A was calculated. Nexl, we created a Spearman-rank correlation matrix showing the association with each of the markers with A-PACHE II. Finally, lo determine the diagnostic and predictive accuracy of all the biomarkers, ROC curves were constructed, and AUCs were calculated. We used SPSS17.0 package for data processing. Results In sepsis group, the VEGF-A, sFLT-1 levels in serum were higher than those in the conlrol group < P < 0. 05) ; In sepsis dealh group, the serum VEGF-A, sFLT-1 levels and aclivily indices of VEGF-A were higher than those in the sepsis survival group(P <0. 05) ; Further more, the serum VEGF-A and sFLT-1 levels and aclivily indices of VEGF-A in sepsis palienls showed positive relationship with the APACHE II score( r = 0. 754, P = 0, r = 0. 655, P =0, r = 0. 497, P =0) . The AUCs of serum VEGF-A, sFLT-1 levels and aclivily indices of VEGF-A lo predict and diagnose sepsis were 0. 763, 0. 764 and 0. 581 respectively; The AUCs of serum VEGF-A, sFLT-1 levels and aclivily indices of VEGF-A predicting 28-day mortality were 0. 912, 0. 862 and 0. 855 respectively. Conclusion Serum VEGF-A and sFLT-1 levels and the aclivily indices of VEGF-A of sipsis palienls were higher than those in conlrol group. Further more, serum VEGF-A and sFLT-1 levels and the aclivily indices of VEGF-A showed positive relationship with APACHE II score; Elevated serum levels of VEGF-A, sFLT-1 and the aclivily indices of VEGF-A can predict sepsis diagnosis and outcome.%目的 观察脓毒症患者血清中VEGF-A、sFLT-1水平变化,以及VEGF-A活性指数(VEGF-A/sFLT-1)变化,探讨其对脓毒症患者的病情评估和预后的预测价值.方法 研究对象脓毒症组为2010年1月-2011年6月期间入住安徽医科大学第一附属医院急诊医学科符合脓毒症诊断标准的59例患者,根据28 d存活情况分为脓毒症存活和死亡组;对照组为20例健康者.采用酶联免疫吸附法测定脓毒症患者和对照组血清中VEGF-A及sFLT-1水平,计算VEGF-A活性指数,分别进行三者与APACHE Ⅱ评分、脓毒症预后的相关性分析.结果 脓毒症组血清VEGF-A、sFLT-1水平均明显高于对照组(P<0.05);脓毒症死亡组血清VEGF-A、sFLT-1水平及VEGF-A活性指数均明显高于存活组(P<0.05);脓毒症组血清VEGF-A、sFLT-1水平及VEGF-A活性指数与APACHE Ⅱ评分均呈正相关性(r=0.754,P=0;r=0.655,P=0;r=0.497,P=0);使用ROC曲线分析血清VEGF-A、sFLT-1浓度和VEGF-A活性指数对脓毒症发生的预测价值,其曲线下面积分别为76.3%、76.4%和58.1%;评估血清VEGF-A、sFLT-1浓度和VEGF-A活性指数对脓毒症预后的预测价值,其ROC曲线下面积分别为91.2%、86.2%和85.5%.结论 脓毒症组血清VEGF-A、sFLT-1水平及VEGF-A活性指数均明显升高,且与病情严重程度以及不良预后呈正相关;血清VEGF-A、sFLT-1水平及VEGF-A活性指数对临床预测脓毒症发生及预后有一定价值.

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  • 来源
    《安徽医药》 |2012年第7期|930-933|共4页
  • 作者

    张启迪; 张泓; 徐俊; 周圆圆; 罗庆礼; 沈继龙;

  • 作者单位

    安徽医科大学第一附属医院急诊医学科,安徽,合肥,230022;

    安徽医科大学第一附属医院急诊医学科,安徽,合肥,230022;

    安徽医科大学第三附属医院急诊医学科,安徽,合肥,230061;

    安徽医科大学第一附属医院急诊医学科,安徽,合肥,230022;

    安徽医科大学重要遗传病基因资源利用教育部省部共建重点实验室,安徽医科大学人兽共患病安徽省重点实验室,安徽,合肥,230032;

    安徽医科大学重要遗传病基因资源利用教育部省部共建重点实验室,安徽医科大学人兽共患病安徽省重点实验室,安徽,合肥,230032;

  • 原文格式 PDF
  • 正文语种 chi
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  • 关键词

    脓毒症; 血管内皮细胞生长因子; 可溶性血管内皮生长因子受体; 活性指数;

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