Secretory non-pancreatic phospholipase A2 in severe sepsis: Relation to endotoxin, cytokines and thromboxane B2
Secretory non-pancreatic phospholipase A2 in severe sepsis: Relation to endotoxin, cytokines and thromboxane B2
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DOI：
10.1007/bf01713312
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发表时间：
1996-03-01
期刊：
影响因子：
7.5
通讯作者：
Offenstadt, G
中科院分区：
文献类型：
--
作者：
Guidet, B;Plot, O;Offenstadt, G
在52例严重脓毒症患者发病时（第0天）以及25例患者发病第1天和第2天前瞻性测定循环分泌型非胰腺磷脂酶A2（snp-PLA 2），以回答两个问题：1）snp-PLA 2血浆浓度是否根据感染的类型和严重程度而不同？2)snp-PLA 2与严重脓毒症中涉及的其他介质如内毒素、细胞因子（TNF α、IL-1 β、IL-6）和血栓素B2（血栓素A2的稳定代谢产物）之间的关系如何？在第0天，严重脓毒症患者的snp-PLA 2循环水平为78 +/- 17 nmol/min/ml，而40名健康志愿者的snp-PLA 2循环水平为3.5 +/- 2 nmol/min/ml。根据第0天的结局、休克的存在或感染类型，没有统计学差异。然而，snp-PLA 2在最终死亡的患者中保持升高甚至增加，而在存活者中降低（通过ANOVA，p = 0.01）。在2天的随访期间，细胞因子谱与snp-PLA 2相似，但存活者与非存活者之间的差异无统计学意义。snp-PLA 2与其他介质的初始值或峰值均无相关性。
Circulatory secretory non-pancreatic phospholipase A2 (snp-PLA2) was measured prospectively at the onset (day 0) of severe sepsis in 52 patients as well as on day 1 and 2 in 25 patients, in order to answer two questions: 1) does the snp-PLA2 plasma concentration differ according to the type and severity of infection? 2) what is the relation between snp-PLA2 and other mediators involved in severe sepsis, such as endotoxin, cytokines (TNF alpha, IL-1 beta, IL-6) and thromboxane B2 (the stable metabolite of thromboxane A2)? On day 0, the snp-PLA2 circulatory level was 78 +/- 17 nmol/min/ml in patients with severe sepsis as compared to 3.5 +/- 2 nmol/min/ml in 40 healthy volunteers. There was no statistical difference according to the outcome, the presence of shock, or the type of infection on day 0. However, snp-PLA2 remained elevated or even increased in patients who ultimately died, while it decreased in survivors (p = 0.01 by ANOVA). The cytokine profiles during the 2-day follow-up were similar to that of snp-PLA2, but the differences were not statistically significant between survivors and non-survivors, No correlation was found between snp-PLA2 and other mediators for either initial or peak values.