Copeptin, a stable peptide of the arginine vasopressin precursor, is elevated in hemorrhagic and septic shock
Copeptin, a stable peptide of the arginine vasopressin precursor, is elevated in hemorrhagic and septic shock
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DOI：
10.1097/shk.0b013e318033e5da
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发表时间：
2007-08-01
期刊：
影响因子：
3.1
通讯作者：
Christ-Crain, Mirjam
中科院分区：
文献类型：
--
作者：
Morgenthaler, Nils G.;Mueller, Beat;Christ-Crain, Mirjam
失血性休克和感染性休克时精氨酸加压素(AVP)水平升高。由于AVP半衰期短、检测方法繁琐，AVP水平的测定具有一定的局限性。Copeptin是一种更稳定的多肽，来自相同的前体分子。我们在两个独立的研究中评估了血浆铜绿素的浓度：第一个是在一个实验性的失血性休克的狒狒模型中，第二个是在一所大学医院对101名连续的危重患者进行的前瞻性观察研究。用两种针对Pre-Pro-AVP C-末端区域(氨基酸序列132-164)的多克隆抗体，用新开发的夹心免疫分析法检测Copeptin。失血性休克患者的Copeptin浓度显著升高，中位数为7.5[2.7-13]至269 pm(241-456 pm)。再灌流后，铜绿素水平在数小时内下降至27 PM(15-78 PM)的平台期。在危重病患者队列中，Copeptin值随病情严重程度的加重而显著升高，在非脓毒症患者[27.6 pm[2.3-297 pm]]、脓毒症患者[50.0 pm[8.5-268 pm]]、严重脓毒症患者[73.6 pm[15.3-317 pm]]和感染性休克患者[171.5 pm(35.1-504 pm)]与健康对照组的4.1 pm(1.0-13.8 pm)相比，差异均有统计学意义(P
Arginine vasopressin (AVP) levels are increased in hemorrhagic and septic shock. Measurement of AVP levels has limitations due to its short half-life and cumbersome detection method. Copeptin is a more stable peptide derived from the same precursor molecule. We evaluated the plasma copeptin concentration in two independent studies: first, in an experimental baboon model of hemorrhagic shock, and second, in a prospective observational study of 101 consecutive critically ill patients at a university hospital. Copeptin was measured with a newly developed sandwich immunoassay using two polyclonal antibodies to the C-terminal region (amino acid sequence 132-164) of pre-pro-AVP. Copeptin concentrations in hemorrhagic shock increased markedly from median (range) of 7.5 [2.7-13) to 269 pM (241-456 pM). After reperfusion, copeptin levels dropped within hours to a plateau of 27 pM (15-78 pM). In the critically ill patient cohort, copeptin values increased significantly with the severity of the disease and were in patients without sepsis [27.6 pM [2.3-297 pM]), in sepsis [50.0 pM [8.5-268 pM]), in severe sepsis [73.6 pM [15.3-317 pM]), and in septic shock [171.5 pM (35.1-504 pM] compared with 4.1 pM (1.0-13.8 pM) in healthy controls (P for all vs. controls