摘要
目的探讨重症脓毒症患者内源性洋地黄因子(EDLF)浓度的变化及在其发病机制中所起的可能作用。方法前瞻性研究2011年3月至2011年12月间首都医科大学附属北京友谊医院中心ICU及急诊ICU诊断为重症脓毒症的患者共43例为实验组,年龄、性别、身高和体重匹配的健康人59例为对照组。通过荧光偏振免疫法(FPIA)测定血清地高辛浓度代表EDLF的测定,TNF-α、IL-1、IL-6、IL-10测定使用酶联免疫吸附法(ELISA)。比较实验组和对照组的EDLF水平,观察实验组患者EDLF与炎性因子的关系以及重症脓毒症患者EDLF与EF的关系。结果实验组EDLF水平明显高于对照组,差异有显著性(P=0.003)。实验组EDLF与超声心动图射血分数呈负相关(r=-0.392,P=0.008),而与TNF-α、IL-1、IL-6及IL-10均无相关性(P=0.544,0.168,0.427,0.303)。实验组EDLF和EF值呈负相关(r=-0.392,P=0.008)。结论重症脓毒症时EDLF循环水平升高,与血液中促炎因子和抑炎因子无关。重症脓毒症时高EDLF可能与脓毒症的发生无关,而是心功能受损、容量负荷过重等因素导致的结果。
Objective To explore the changes in concentration of endogenous digitalis factor(EDLF) in patients with severe sepsis and its possible role in the pathogenesis of sepsis.Methods A total of 43 patients with severe sepsis were randomly allocated in experimental group,they were admitted in ICU and emergency ICU of Beijing Friendship Hospital during March 2011 to December 2011.59 healthy persons with similar age,gender,height and weight were allocated as control group.The determination of serum digoxin concentration represented EDLF had been carried out by fluorescent polarization immunoassay(FPIA).Serum levels of TNF-α,IL-1,IL-6 and IL-10 were measured by using enzyme-linked immunosorbent assay(ELISA).The EDLF levels of patients in experimental group and control group were compared.The relationship between EDLF and inflammatory factors in experimental group and the relationship between EDLF and EF in patients with severe sepsis were observed.Results In comparison with experimental group and control group,there was significant difference in EDLF level(P = 0.003).The EDLF and EF values of experimental group were negatively correlated(r =-0.392,P = 0.008).There was no correlation among serum levels of TNF-α,IL-1,IL-6 and IL-10(P = 0.544,0.168,0.427,0.303).Conclusion The circulating level of EDLF in patients with severe sepsis is higher than that of normal persons.But there is no relationship between EDLF and inflammatory cytokines in the blood.These results suggest that EDLF does not contribute to the occurrence of sepsis.Impaired cardiac function in sepsis,overload volume and other factors may lead to this result.
出处
《临床和实验医学杂志》
2018年第3期317-321,共5页
Journal of Clinical and Experimental Medicine
基金
北京市教育委员会科技发展计划面上项目(编号:KM201310025016)
关键词
脓毒症
内源性洋地黄因子
炎性因子
Sepsis
EDLF-Endogenous digitalis factor
Inflammatory factors
