Serum vascular endothelial growth factor in adult haematological patients with neutropenic fever: a comparison with C-reactive protein
Serum vascular endothelial growth factor in adult haematological patients with neutropenic fever: a comparison with C-reactive protein
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DOI：
10.1111/j.1600-0609.2009.01260.x
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发表时间：
2009-09-01
影响因子：
3.1
通讯作者：
Jantunen, Esa
中科院分区：
文献类型：
--
作者：
Hamalainen, Sari;Juutilainen, Auni;Jantunen, Esa
目的：血管内皮生长因子（VEGF）在脓毒症中起重要作用。没有数据可在血液病患者与血小板减少fever.Methods：42例血液病患者纳入这项前瞻性研究的VEGF动力学。中位年龄为57岁（范围18-70岁）。15例患者接受了急性髓性白血病治疗，27例患者接受了自体干细胞移植治疗血液系统恶性肿瘤。实验室样本的C-反应蛋白（CRP）和VEGF的测定收集在开始发烧（D 0），然后每天。结果：中位血清VEGF浓度低，在所有研究患者。在严重脓毒症患者中（n = 5），d 0时的中位VEGF高于无低灌注或低血压体征的脓毒症患者（n = 37）（77 pg/mL vs. 52 pg/mL，P = 0.061）。同样在第1天，重度脓毒症患者的中位VEGF浓度较高（82 pg/mL vs. 56 pg/mL，P = 0.048）。在研究期间的任何一天，严重脓毒症患者与非严重脓毒症患者之间的CRP值均无统计学显著差异。VEGF达峰时间（平均1.02，SE 0.18 d）较CRP达峰时间（平均1.93，SE 0.15 d）短（P = 0.002）。结论：血清VEGF较CRP更能快速反映血液病败血症患者的病情。严重脓毒症患者在发热后第0天和第1天的VEGF浓度高于无脓毒症患者。需要在血液病患者中进一步研究VEGF。
Objectives:Vascular endothelial growth factor (VEGF) is considered to be of importance in patients with sepsis. No data are available on VEGF kinetics in haematological patients with neutropenic fever.Methods:Forty-two haematological patients were included into this prospective study. Median age was 57 yr (range 18-70). Fifteen patients received therapy for acute myeloid leukaemia and 27 patients received autologous stem cell transplantation for haematological malignancy. Laboratory samples for the determination of C-reactive protein (CRP) and VEGF were collected at the start of fever (d0) and then daily.Results:The median serum VEGF concentrations were low in all study patients. In patients with severe sepsis (n = 5) the median VEGF on d0 was higher than in septic patients without signs of hypoperfusion or hypotension (n = 37) (77 pg/mL vs. 52 pg/mL, P = 0.061). Also on d1 the median VEGF concentration was higher in patients with severe sepsis (82 pg/mL vs. 56 pg/mL, P = 0.048). There were no statistically significant differences in CRP values on any day during the study period between patients with severe sepsis and those without. Time from d0 to the peak VEGF concentration (mean 1.02, SE 0.18 d) was shorter than that to the peak CRP concentration (mean 1.93, SE 0.15 d) (P = 0.002).Conclusion:Compared to CRP, serum VEGF was a more rapid indicator for sepsis in our haematological patients with neutropenic fever. Those with severe sepsis had higher VEGF concentrations than those without on d0 and d1 after the onset of fever. Further studies on VEGF are warranted in haematological patients.