Assessment of Apoptosis Inhibitor of Macrophage/CD5L as a Biomarker to Predict Mortality in the Critically Ill With Sepsis
Assessment of Apoptosis Inhibitor of Macrophage/CD5L as a Biomarker to Predict Mortality in the Critically Ill With Sepsis
复制标题
评估巨噬细胞凋亡抑制剂/CD5L 作为预测脓毒症危重患者死亡率的生物标志物
DOI：
10.1016/j.chest.2019.04.134
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发表时间：
2019-10-01
期刊：
影响因子：
9.6
通讯作者：
Cao, Ju
中科院分区：
文献类型：
--
作者：
Gao, Xun;Liu, Yi;Cao, Ju
背景：确定巨噬细胞凋亡抑制因子(AIM)/CD5L作为一种潜在的新生物标志物在重症脓毒症患者的发病率和死亡率中的作用。测定ICU入院当天血清AIM水平，并与生存状态、器官功能障碍进行比较。为了验证，来自另一个医学中心的60名成年脓毒症患者进行了研究。结果：在成人患者的派生队列中，脓毒症患者的入院血清AIM水平显著高于ICU对照组和健康对照组。入院时较高的血清AIM水平与较高的序贯(败血症相关)器官衰竭评估(SOFA)评分显著相关。在ICU入院当天，AIM水平与28d死亡率相关的受试者工作特征曲线下面积(AUC)为0.86，高于SOFA(0.77)、降钙素原(0.73)、乳酸(0.67)、IL-27(0.65)和C反应蛋白(0.55)的AUC。与AIM水平较低的脓毒症患者相比，AIM入院水平较高(>；543.66 ng/mL)的脓毒症患者的28天死亡率显著增加(
BACKGROUND: To determine the utility of apoptosis inhibitor of macrophage (AIM)/CD5L as a potentially novel biomarker of morbidity and mortality in patients with sepsis who are critically ill.METHODS: There were 150 adult patients with sepsis studied. Serum AIM levels on day of ICU admission were determined and compared with survival status and organ dysfunction. For validation, 60 adult patients with sepsis from another medical center were studied. Furthermore, the role of AIM as an outcome predictor in 51 pediatric patients with sepsis was investigated.RESULTS: In the derivation cohort of adult patients, patients with sepsis had markedly increased admission levels of serum AIM compared with ICU control subjects and healthy control subjects. Higher serum AIM levels at admission were significantly associated with higher Sequential (sepsis-related) Organ Failure Assessment (SOFA) scores. On day of ICU admission, the area under the receiver operating characteristic curve (AUC) for AIM level association with 28-day mortality was 0.86, higher than the AUC for SOFA (0.77), procalcitonin (0.73), lactate (0.67), IL-27 (0.65), and C-reactive protein (0.55). Patients with sepsis with higher admission levels of AIM (> 543.66 ng/mL) had significantly increased 28- day mortality compared with those with lower AIM levels (