中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
13期
2424-2427
,共4页
宋景春%林兆奋%王浈%杨洋%陈自力
宋景春%林兆奮%王湞%楊洋%陳自力
송경춘%림조강%왕정%양양%진자력
脓毒症%趋化因子CCL5%诊断%预后
膿毒癥%趨化因子CCL5%診斷%預後
농독증%추화인자CCL5%진단%예후
Sepsis%Chemokine CCL5%Diagnosis%Prognosis
目的：检测严重脓毒症患者血清中受激活调节正常T细胞表达和分泌因子（RANTES）水平，并评价其对严重脓毒症的诊断和预后价值。方法选取严重脓毒症患者40例为严重脓毒症组（SS组），同期门诊体检者20例为对照组，收集临床及实验室参数，计算APACHEⅡ评分和 DIC 评分，采用酶联免疫吸附测定（ELISA）方法检测血清 RANTES 的水平。结果 SS组患者血清RANTES水平[（3175.91±1341.78）pg/ml]较对照组[（5374.27±927.87）pg/ml]下降（P＜0.05）。相关分析显示RANTES与WBC、PLT、AST、TBIL、Cr、PT、APTT、PCT、APACHEⅡ评分和DIC评分均呈显著负相关（P＜0.05），显示RANTES诊断严重脓毒症的AUCSS＝0.917，95%CI 0.817～0.993（P＜0.05），判断严重脓毒症死亡的AUCdeath＝0.786，95%CI 0.650～0.922（P＜0.05）。结论严重脓毒症患者的血清RANTES水平明显降低，并死亡率升高，对严重脓毒症的诊断和预后判断有较好的价值。
目的：檢測嚴重膿毒癥患者血清中受激活調節正常T細胞錶達和分泌因子（RANTES）水平，併評價其對嚴重膿毒癥的診斷和預後價值。方法選取嚴重膿毒癥患者40例為嚴重膿毒癥組（SS組），同期門診體檢者20例為對照組，收集臨床及實驗室參數，計算APACHEⅡ評分和 DIC 評分，採用酶聯免疫吸附測定（ELISA）方法檢測血清 RANTES 的水平。結果 SS組患者血清RANTES水平[（3175.91±1341.78）pg/ml]較對照組[（5374.27±927.87）pg/ml]下降（P＜0.05）。相關分析顯示RANTES與WBC、PLT、AST、TBIL、Cr、PT、APTT、PCT、APACHEⅡ評分和DIC評分均呈顯著負相關（P＜0.05），顯示RANTES診斷嚴重膿毒癥的AUCSS＝0.917，95%CI 0.817～0.993（P＜0.05），判斷嚴重膿毒癥死亡的AUCdeath＝0.786，95%CI 0.650～0.922（P＜0.05）。結論嚴重膿毒癥患者的血清RANTES水平明顯降低，併死亡率升高，對嚴重膿毒癥的診斷和預後判斷有較好的價值。
목적：검측엄중농독증환자혈청중수격활조절정상T세포표체화분비인자（RANTES）수평，병평개기대엄중농독증적진단화예후개치。방법선취엄중농독증환자40례위엄중농독증조（SS조），동기문진체검자20례위대조조，수집림상급실험실삼수，계산APACHEⅡ평분화 DIC 평분，채용매련면역흡부측정（ELISA）방법검측혈청 RANTES 적수평。결과 SS조환자혈청RANTES수평[（3175.91±1341.78）pg/ml]교대조조[（5374.27±927.87）pg/ml]하강（P＜0.05）。상관분석현시RANTES여WBC、PLT、AST、TBIL、Cr、PT、APTT、PCT、APACHEⅡ평분화DIC평분균정현저부상관（P＜0.05），현시RANTES진단엄중농독증적AUCSS＝0.917，95%CI 0.817～0.993（P＜0.05），판단엄중농독증사망적AUCdeath＝0.786，95%CI 0.650～0.922（P＜0.05）。결론엄중농독증환자적혈청RANTES수평명현강저，병사망솔승고，대엄중농독증적진단화예후판단유교호적개치。
ObjectiveTo examine the levels of serum regulated upon activation normal T cell expressed and secreted (RANTES) from severe sepsis patients in an effect to evaluate the value for prognosis and diagnosis for severe sepsis.MethodsSixty patients were divided into 2 groups, severe sepsis group (SS group, 40 cases) and normal group(20 cases). Clinical data of these patients were collected, including APACHEⅡscore and DIC score. Serum levels of RANTES were measured in patients by ELISA.ResultsThe patients of SS group had lower levels of RANTES[(3 175.91±1 341.78)pg/ml] than the healthy control[(5 374.27±927.87)pg/ml](P<0.05). There were significant negative correlations between RANTES and WBC, PLT, AST, TBIL, Cr, PT, APTT, PCT, APACHEⅡ score and DIC score (P<0.05). The areas under the curves (AUC) of RANTES for severe sepsis was 0.917,95%CI=0.817-0.993(P<0.05), and AUC of RANTES for death was 0.786, 95%CI=0.650-0.922(P<0.05). Conclusion Serum levels of RANTES in patients with severe sepsis significantly decreased, which maybe benefit diagnosis and prognosis for severe sepsis.
