Plasma HSPA12B is a potential predictor for poor outcome in severe sepsis.
Plasma HSPA12B is a potential predictor for poor outcome in severe sepsis.
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血浆 HSPA12B 是严重败血症预后不良的潜在预测因子
DOI：
10.1371/journal.pone.0101215
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Zhu KM
中科院分区：
文献类型：
--
作者：
Zhang R;Wan XJ;Zhang X;Kang QX;Bian JJ;Yu GF;Wang JF;Zhu KM
前言内皮衍生分子可能是器官损伤的预测指标。热休克蛋白(HSP)A12b主要定位于内皮细胞，可在脓毒症患者血浆中检测到。它是否与脓毒症的预后相关尚不清楚。方法检测盲肠结扎穿孔(CLP)后6h、12h、2 4h和48h脓毒症小鼠血浆中细胞外HSPA12B(EHSPA12B)的含量。在严重脓毒症、脓毒症、全身炎症反应综合征患者和健康志愿者的血浆中也检测到它。用受试者操作曲线(ROC)和COX回归分析评价其对严重脓毒症预后的预测价值。结果CLP小鼠血浆中eHSPA12B于术后6h开始升高，术后24小时达高峰。纳入临床病例118例，其中严重脓毒症66例，脓毒症21例，全身炎症反应综合征16例，志愿者15例。严重脓毒症患者的血浆eHSPA12B水平显著高于脓毒症患者、全身炎症反应综合征患者和志愿者。死亡患者的eHSPA12B水平也高于存活的严重脓毒症患者。在ROC分析中，eHSPA12B预测严重脓毒症患者死亡的曲线下面积为0.782(0.654~0.909)，明显高于IL-6和IL-10。COX回归分析显示，心血管疾病、IL-6、eHSPA12B是严重脓毒症患者死亡的危险因素。生存曲线显示，eHSPA12B低于或不低于1.466 ng/ml的患者28天存活率差异有统计学意义。这可能是严重脓毒症患者预后不良的一个很好的预测指标。
Introduction Endothelium-derived molecules may be predictive to organ injury. Heat shock protein (HSP) A12B is mainly located in endothelial cells, which can be detected in the plasma of septic patients. Whether it is correlated with prognosis of sepsis remains unclear. Methods Extracellular HSPA12B (eHSPA12B) was determined in plasma of septic mice at 6h, 12h, 24h and 48h after cecal ligation and puncture (CLP). It was also detected in plasma of patients with severe sepsis, sepsis, systemic inflammatory response syndrome and healthy volunteers. The predictive value for prognosis of severe sepsis was assessed by receiver operating curve (ROC) and Cox regression analyses. Results eHSPA12B was elevated in plasma of CLP mice at 6h and peaked at 24h after surgery. A total of 118 subjects were included in the clinical section, including 66 patients with severe sepsis, 21 patients with sepsis, 16 patients with SIRS and 15 volunteers. Plasma eHSPA12B was significantly higher in patients with severe sepsis than in patients with sepsis, SIRS and volunteers. The level of eHSPA12B was also higher in non-survivals than survivals with severe sepsis. The area under the curve (AUC) of eHSPA12B in predicting death among patients with severe sepsis was 0.782 (0.654–0.909) in ROC analysis, much higher than that of IL-6 and IL-10. Cox regression analysis showed that cardiovascular diseases, IL-6 and eHSPA12B were risk factors for mortality in patients with severe sepsis. Survival curve demonstrated a strikingly significant difference between 28-day survival rates of patients with an eHSPA12B lower or not lower than 1.466ng/ml. Conclusions Plasma eHSPA12B is elevated in both septic mice and patients. It may be a good predictor for poor outcome in patients with severe sepsis.
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