Use of blood urea nitrogen, creatinine, interleukin-6, granulocyte-macrophage colony stimulating factor in combination to predict the severity and outcome of abdominal sepsis in rats
Use of blood urea nitrogen, creatinine, interleukin-6, granulocyte-macrophage colony stimulating factor in combination to predict the severity and outcome of abdominal sepsis in rats
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联合使用血尿素氮、肌酐、白细胞介素6、粒细胞巨噬细胞集落刺激因子预测大鼠腹部脓毒症的严重程度和结局
DOI：
10.1007/s00011-012-0481-3
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发表时间：
2012-08-01
影响因子：
6.7
通讯作者：
Xiao, Xianzhong
中科院分区：
文献类型：
--
作者：
Gao, Min;Zhang, Lingli;Xiao, Xianzhong
脓毒症的准确和及时诊断和预后仍然具有挑战性。与单一标记物相比，标记物的组合可以改善预后，从而改善生存。本研究比较了常规使用的脓毒症生物标志物单独和联合用于预测腹腔脓毒症大鼠结局的有效性。CLP后12 h检测到17种生物标志物。分析这些生物标志物与大鼠预后的相关性，并对相关生物标志物进行Logistic回归分析，计算受试者工作特征（ROC）曲线下面积，比较它们在脓毒症预后中的表现，共49只大鼠符合分析条件。CLP后体温（T）、血尿素氮（BUN）、肌酐（Cr）、丙氨酸氨基转移酶（ALT）、肌酸激酶（CK）、白细胞介素-6（IL-6）和单核细胞趋化蛋白-1（MCP-1）水平与生存结局呈负相关，而血小板计数（PLT）、高迁移率族蛋白B1（HMGB 1）和粒细胞-巨噬细胞集落刺激因子（GM-CCF）与生存结局呈正相关（P < 0.05）。根据条件Logistic回归分析，CLP后BUN、Cr、IL-6和GM-CSF水平是结局的独立预测因素。4种生物标志物联合应用预测脓毒症预后的敏感性和特异性均优于单独应用（P <0. 05），联合应用可提高脓毒症的诊断准确性，对脓毒症的预后判断更有效。联合应用BUN、Cr、IL-6、GM-CSF预测腹腔脓毒症大鼠的严重程度和预后具有可接受的诊断特征。
Accurate and timely diagnosis and prognosis of sepsis remain challenging. A combination of markers, as opposed to single ones, may improve the prognosis, and therefore survival. This study compared the effectiveness of routinely used biomarkers of sepsis alone and in combination for the prediction of outcome in rats with abdominal sepsis.Rats were subjected to sepsis induced by cecal ligation and puncture (CLP). Seventeen biomarkers were detected 12 h after the CLP. Correlation between the biomarkers and outcome of rats was analyzed; the correlated biomarkers were analyzed by logistic regression analysis and the area under the receiver operating characteristic (ROC) curve was computed to compare their performance in the prognosis of sepsis.A total of 49 rats were eligible for analysis. Body temperature (T), blood urea nitrogen (BUN), creatinine (Cr), alanine aminotransferase (ALT), creatine kinase (CK), interleukin-6 (IL-6) and monocyte chemoattractant protein-1 (MCP-1) levels after the CLP were negatively correlated with the survival outcome, while platelet count (PLT), high-mobility group box protein 1 (HMGB1) and granulocyte-macrophage colony stimulating factor (GM-CCF) were positively correlated with the survival outcome (P < 0.05). Levels of BUN, Cr, IL-6, and GM-CSF after the CLP were independent predictors of outcome according to conditional logistic regression. The sensitivity and specificity of the four selected biomarkers in combination for predicting sepsis outcome were better than single ones (P < 0.05).A combination of different biomarkers improves the diagnostic accuracy and is more effective in the prognosis of sepsis in rats. Use of BUN, Cr, IL-6, GM-CSF in combination to predict the severity and outcome in rats with abdominal sepsis exhibited acceptable diagnostic characteristics.