Plasma Monocyte Chemoattractant Protein 1 as a Predictive Marker for Sepsis Prognosis: A Prospective Cohort Study.
Plasma Monocyte Chemoattractant Protein 1 as a Predictive Marker for Sepsis Prognosis: A Prospective Cohort Study.
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DOI：
10.1620/tjem.241.139
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发表时间：
2017-02
期刊：
影响因子：
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通讯作者：
T. Zhu;X. Liao;T. Feng;Qihong Wu;Jiang-qian Zhang;X. Cao;Hong Li
中科院分区：
文献类型：
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作者：
T. Zhu;X. Liao;T. Feng;Qihong Wu;Jiang-qian Zhang;X. Cao;Hong Li
脓毒症是宿主对感染的全身性反应，脓毒症患者通常在重症监护病房处理。然而，与败血症相关的死亡率在全世界仍然很高。此外，在临床实践中还没有有效的脓毒症预后生物标志物。因此，我们旨在使用趋化因子/细胞因子阵列确定脓毒症的预后生物标志物。本研究纳入143例败血症患者，根据28天死亡率分为存活组和非存活组。每个败血症组随机选择两名患者的血浆样本进行细胞因子阵列分析。因此，我们确定了七种细胞因子在非幸存者和幸存者之间具有显著和一致的不同表达水平。然后用酶联免疫吸附试验（ELISA）评估所选细胞因子的有效性。我们最终发现单核细胞化学引诱蛋白1 （MCP-1）是区分两组败血症的最有用的生物标志物；即，非存活患者（n = 56）的血浆MCP-1浓度明显高于存活患者（n = 87）。MCP-1是一种CC趋化因子，是一种有效的趋化剂，有助于全身炎症反应综合征。预测28天死亡率的受试者工作特征曲线下面积MCP-1为0.763，急性生理评估和慢性健康评估II （APACHE II）评分为0.680，顺序器官衰竭评估（SOFA）评分为0.64，降钙素原为0.621，MCP-1 + APACHE II评分为0.785。总之，我们认为血浆MCP-1是预测脓毒症预后的有用生物标志物。
Sepsis is a systemic host response to infection, and patients with sepsis are frequently handled in the intensive care unit. However, mortality related to sepsis remains high throughout the world. In addition, there have been no efficient prognostic biomarkers for sepsis to be employed in clinical practice. We therefore aimed to identify prognostic biomarkers for sepsis using the chemokine/cytokine array. This study included 143 patients with sepsis, who were divided into survivor and nonsurvivor groups according to their 28-day mortality status. The cytokine array analysis was performed with plasma samples from two randomly selected patients in each sepsiofgroup. We thus identified seven cytokines with significantly and consistently different expression levels between nonsurvivors and survivors. The validity of the selected cytokines was then assessed by enzyme-linked immunosorbent assay (ELISA). We finally found monocyte chemoattractant protein 1 (MCP-1) as the most useful biomarker to distinguish the two sepsis groups; namely, non-surviving patients (n = 56) exhibited significantly higher plasma concentrations of MCP-1 compared to survivors (n = 87). MCP-1 is a CC chemokine, a potent chemoattractant that contributes to systemic inflammatory response syndrome. Areas under the receiver operating characteristic curves for prediction of 28-day mortality were 0.763 for MCP-1, 0.680 for the Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II) score, 0.64 for the Sequential Organ Failure Assessment (SOFA) score, 0.621 for procalcitonin, and 0.785 for MCP-1 plus APACHE II score. In conclusion, we propose that plasma MCP-1 is a useful biomarker in predicting outcome of sepsis.