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血浆肝细胞生长因子在脓毒症中的预后意义。

Prognostic Significance of Plasma Hepatocyte Growth Factor in Sepsis.

机构信息

Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, People's Republic of China.

出版信息

J Intensive Care Med. 2022 Mar;37(3):352-358. doi: 10.1177/0885066621993423. Epub 2021 Feb 22.

Abstract

BACKGROUND

To assess any correlation of plasma hepatocyte growth factor (HGF) levels with relevant endothelial cell injury parameters and determine the prognostic value in septic patients.

METHODS

A prospective, observational study was conducted in patients with sepsis admitted to the Department of Critical Care Medicine at the Zhongda Hospital from November 2017 to March 2018. Plasma HGF levels were measured by enzyme-linked immunosorbent assay in the first 24 h after admission (day 1) and on day 3. The primary endpoint was defined as all-cause 28-day mortality. Furthermore, we analyzed the correlation of HGF with relevant endothelial cell injury markers.

RESULTS

Eighty-six patients admitted with sepsis were included. HGF levels of nonsurvivors were elevated compared to those of survivors on day 1 (1940.62 ± 74.66 pg/mL vs. 1635.61 ± 47.49 pg/mL; = 0.002) and day 3 (1824.82 ± 137.52 pg/mL vs. 1309.77 ± 83.49 pg/mL; = 0.001) and showed a strong correlation with von Willebrand factor (r = 0.45, < 0.0001), lactate (r = 0.35, = 0.0011), pulmonary vascular permeability index (r = 0.38, = 0.0241), first 24 h fluid administration (r = 0.38, < 0.0001), and sequential organ failure assessment score (r = 0.40, = 0.0001). Plasma HGF levels were able to prognostically discriminate between survivors and nonsurvivors on day 1 (AUC: 0.72, 95%CI: 0.60-0.84) and day 3 (AUC: 0.77, 95%CI: 0.63-0.91).

CONCLUSIONS

HGF levels are associated with sepsis and correlated with established markers of endothelial cell injury. Elevated HGF levels in sepsis patients are an efficient indicator of poor prognosis.

TRIAL REGISTRATION

The study was registered in Clinical Trial (Registration Number: NCT02883231).

摘要

背景

评估血浆肝细胞生长因子(HGF)水平与相关内皮细胞损伤参数的相关性,并确定其在脓毒症患者中的预后价值。

方法

对 2017 年 11 月至 2018 年 3 月在中大医院重症医学科收治的脓毒症患者进行前瞻性观察性研究。在入院后 24 小时内(第 1 天)和第 3 天通过酶联免疫吸附试验测量血浆 HGF 水平。主要终点定义为全因 28 天死亡率。此外,我们分析了 HGF 与相关内皮细胞损伤标志物的相关性。

结果

共纳入 86 例脓毒症患者。与存活者相比,第 1 天(1940.62±74.66 pg/mL 比 1635.61±47.49 pg/mL; = 0.002)和第 3 天(1824.82±137.52 pg/mL 比 1309.77±83.49 pg/mL; = 0.001)的死亡患者 HGF 水平升高,且与血管性血友病因子(r = 0.45, <0.0001)、乳酸(r = 0.35, = 0.0011)、肺血管通透性指数(r = 0.38, = 0.0241)、第 1 天 24 小时液体摄入量(r = 0.38, <0.0001)和序贯器官衰竭评估评分(r = 0.40, = 0.0001)呈强相关。第 1 天(AUC:0.72,95%CI:0.60-0.84)和第 3 天(AUC:0.77,95%CI:0.63-0.91)的 HGF 水平能够预测患者的生存情况。

结论

HGF 水平与脓毒症相关,并与已建立的内皮细胞损伤标志物相关。脓毒症患者 HGF 水平升高是预后不良的有效指标。

试验注册

本研究已在临床试验(注册号:NCT02883231)中注册。

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