Plasma nuclear and mitochondrial DNA levels as predictors of outcome in severe sepsis patients in the emergency room.
Plasma nuclear and mitochondrial DNA levels as predictors of outcome in severe sepsis patients in the emergency room.
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DOI：
10.1186/1479-5876-10-130
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发表时间：
2012-06-21
影响因子：
7.4
通讯作者：
Lu CH
中科院分区：
文献类型：
--
作者：
Kung CT;Hsiao SY;Tsai TC;Su CM;Chang WN;Huang CR;Wang HC;Lin WC;Chang HW;Lin YJ;Cheng BC;Su BY;Tsai NW;Lu CH
用于预测严重脓毒症患者死亡率的生物标志物和评分系统的敏感性和特异性仍然不能令人满意。本研究旨在确定急诊科 (ED) 就诊的严重脓毒症患者循环血浆 DNA 水平的预后价值。对 67 名连续患有严重脓毒症的患者和 33 名对照进行了评估。使用人β-血红蛋白和ND2基因的引物通过实时定量聚合酶链反应测定来估计血浆DNA水平。对患者入院时的临床和实验室数据进行分析。严重脓毒症患者入院时血浆核和线粒体 DNA 水平中位数显着高于对照组。入院时平均血浆核DNA水平与入院时乳酸浓度（γ = 0.36，p = 0.003）和入院时血浆线粒体DNA（γ = 0.708，p < 0.001）相关。死亡的重要预后因素包括前24小时内的机械通气（p = 0.013）、入院时平均序贯器官衰竭评估（SOFA）评分（p = 0.04）、血清乳酸（p < 0.001）以及入院时血浆核和线粒体DNA（p < 0.001）。通过逐步逻辑回归分析，血浆线粒体 DNA 是死亡率的独立预测因子，水平每增加 1 ng/mL，死亡率就会增加 0.7%。血浆 DNA 可用于预测到达急诊室的脓毒症患者的结果。入院时血浆线粒体 DNA 水平是比入院时乳酸浓度或 SOFA 评分更强大的预测因子。
The sensitivity and specificity of biomarkers and scoring systems used for predicting fatality of severe sepsis patients remain unsatisfactory. This study aimed to determine the prognostic value of circulating plasma DNA levels in severe septic patients presenting at the Emergency Department (ED). Sixty-seven consecutive patients with severe sepsis and 33 controls were evaluated. Plasma DNA levels were estimated by real-time quantitative polymerase chain reaction assay using primers for the human β-hemoglobin and ND2 gene. The patients’ clinical and laboratory data on admission were analyzed. The median plasma nuclear and mitochondria DNA levels for severe septic patients on admission were significantly higher than those of the controls. The mean plasma nuclear DNA level on admission correlated with lactate concentration (γ = 0.36, p = 0.003) and plasma mitochondrial DNA on admission (γ = 0.708, p < 0.001). Significant prognostic factors for fatality included mechanical ventilation within the first 24 hours (p = 0.013), mean sequential organ failure assessment (SOFA) score on admission (p = 0.04), serum lactate (p < 0.001), and both plasma nuclear and mitochondrial DNA on admission (p < 0.001). Plasma mitochondrial DNA was an independent predictor of fatality by stepwise logistic regression such that an increase by one ng/mL in level would increase fatality rate by 0.7%. Plasma DNA has potential use for predicting outcome in septic patients arriving at the emergency room. Plasma mitochondrial DNA level on admission is a more powerful predictor than lactate concentration or SOFA scores on admission.
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影响因子：
64.8
作者：
TSUMITA, T;IWANAGA, M
通讯作者：
IWANAGA, M
影响因子：
6.5
作者：
Huang, Chien-Hua;Tsai, Min-Shan;Chen, Wen-Jone
通讯作者：
Chen, Wen-Jone
影响因子：
3.7
作者：
Huttunen R;Kuparinen T;Jylhävä J;Aittoniemi J;Vuento R;Huhtala H;Laine J;Syrjänen J;Hurme M
通讯作者：
Hurme M
影响因子：
9.3
作者：
Chiu, RWK;Chan, LYS;Lo, YMD
通讯作者：
Lo, YMD
影响因子：
9.3
作者：
Saukkonen, Katri;Lakkisto, Paivi;Pulkki, Kari
通讯作者：
Pulkki, Kari