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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

19卷

期数:

2013年06期

页码:

474-477

栏目:

临床医学

出版日期:

2013-11-20

文章信息/Info

Title:

Correlation between Angiopoietin-2 and pulmonary capillary leak in severe septic patients

作者:

温占兵¹; 李真玉²; 刘 健²; 刘德梦³

1.天津医科大学研究生院，天津 300070；2.天津医科大学第二医院ICU，天津 300211；3.天津医科大学第二医院感染病研究所，天津 300211

Author(s):

WEN Zhan-bing¹; LI Zhen-yu²; LIU Jian²; LIU De-meng³

1. Graduate School，Tianjin Medical University，Tianjin 300070，China；2. ICU，The Second Hospital，Tianjin Medical University，Tianjin 300211，China；3. Institute of Infectious Diseases，The Second Hospital ，Tianjin Medical University，Tianjin 300211，China

关键词:

血管生成素-2; 严重脓毒症; 肺水肿; 血管外肺水指数

Keywords:

angiopoietin-2; severe sepsis; pulmonary edema;  extravascular lung water index

分类号:

R631

DOI:

-

文献标志码:

A

摘要:

目的：探讨血清血管生成素-2（Ang-2）水平在严重脓毒症患者发病不同时间预测渗漏性肺水肿的价值。方法：采用前瞻性设计，将42例发病后6 h内收入院的严重脓毒症患者，按照血管外肺水指数（EVLWI）值，分为渗漏组及非渗漏组，另选同期门诊健康体检者20例为对照组。所有患者入院后第0（入院时）、1、3、5天清晨抽取外周静脉血离心取血清，酶联免疫吸附法检测Ang-2浓度，记录每天的EVLWI值。采用t检验比较两组间血清Ang-2水平的差异，接收者工作特征曲线（ROC曲线）下面积法检验Ang-2的预测效力，Spearman秩相关分析Ang-2与EVLWI的相关性。结果：与对照组相比，严重脓毒症患者发病后各时间点血清Ang-2均明显升高，差异有统计学意义（P<0.01）；渗漏组与非渗漏组相比，第0、1天血清Ang-2水平显著升高，差异有统计学意义（P<0.05），第3、5天血清Ang-2水平两组间比较，差异无统计学意义（P>0.05）；第0天血清Ang-2预测渗漏性肺水肿的曲线下面积为0.748（P<0.01，95%CI: 0.548~0.912）；相关性分析显示，第0天Ang-2与EVLWI有显著相关性，r=0.732（P<0.01）。结论：发病早期（12 h内）明显升高的Ang-2对判断严重脓毒症渗漏性肺水肿的形成有一定的临床价值。

Abstract:

Objective: To investigate the clinical effect of serum angiopoietin-2(Ang-2) levels in predicting permeable pulmonary edema in severe septic patients. Methods: A total of 42 patients who were suffering from severe sepsis were enrolled in this study. According to extravascular lung water index(EVLWI) on admission，all patients were divided into leaky group(n=15) and non-leaky group(n=27) ， while 20 healthy volunteers from out-patient department were studied as control group. Peripheral blood samples were collected on admission and the morning of 1st，3rd and 5th days. Ang-2 levels were measured using ELISA. EVLWI was recorded for five consecutive days. Ang-2 levels between the two groups were compared using Student’s t-test. The validity of predicting severe septic patients’ pulmonary capillary leak with Ang-2 levels was verified by receiver operating characteristic curves (ROC curves). Spearman rank correlation was used to analyze the correlation between Ang-2 levels and EVLWI at different times. Results: Ang-2 levels in severe septic group was significantly higher than that in control group（P<0.01）； Ang-2 levels in leaky group was significantly higher than that in non-leaky group on admission and the 1st day（P<0.05） but no significant difference between the two groups were found on the 3rd and 5th days（P>0.05）； ROC curves area of Ang-2 levels on admission for predicting the permeable pulmonary edema was 0.748 (P<0.01，95%CI: 0.548-0.912)；Ang-2 levels was positively correlated to EVLWI on admission，r =0.732（P<0.01）. Conclusion: Ang-2 elevated significantly in the early course has certain clinical effect in predicting permeable pulmonary edema in severe septic patients.

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备注/Memo

备注/Memo:

作者简介 温占兵（1982-），男，硕士在读，研究方向：感染性疾病基础与临床；通信作者：刘德梦，E-mail:tjlf@eyou.com。

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更新日期/Last Update: 2013-12-20