摘要
目的探讨细菌感染患者血清载脂蛋白M（apo M）与感染程度的相关性。方法以临床诊断为感染无全身炎症反应综合征（SIRS）患者及脓毒血症、严重脓毒血症、脓毒血症休克患者为病例组,同期体检中心无感染、发热的个体为对照组,检测各组研究对象血清apo M、降钙素原（PCT）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白AⅠ（apo AⅠ）、载脂蛋白B（apo B）、脂蛋白（a）[Lp（a）]、C反应蛋白（CRP）水平,观察不同感染阶段apo M与其他指标的水平变化及其与PCT的相关性。结果对照组、感染无SIRS组、脓毒血症组、严重脓毒血症组和脓毒血症休克组apo M浓度[M（P25,P75）]分别为11.20（9.13,13.16）、15.01（9.16,19.72）、3.21（2.27,4.57）、3.23（2.25,5.84）、2.51（1.16,3.98）μg/mL。与对照组比较,脓毒血症组、严重脓毒血症组及脓毒血症休克组apo M水平下降（t分别为9.70、9.26、11.52,P均〈0.01）;与感染无SIRS组比较,脓毒血症组、严重脓毒血症组和脓毒血症休克组apo M水平下降（t分别为10.57、10.12、12.39,P均〈0.01）;与脓毒血症组比较,脓毒血症休克组apo M水平下降无统计学意义（t=1.82,P〉0.05）;与严重脓毒血症组比较,脓毒血症休克组apo M水平下降（t=2.20,P〈0.05）。血清apo M在机体感染状态下与PCT呈高度负相关（r=-0.703,P=0.000）。apo M诊断感染的ROC曲线下面积为0.839（95%CI：0.754~0.923）。结论血清apo M水平随细菌感染程度加深而下降,有望成为判断感染严重程度的指标。
Objective To investigate the correlation between the concentration of serum apolipoprotein M（apo M） and the severity of illnesses in the patients with bacterial infection.Methods Serum samples were collected from the patients with infections unaccompanied by inflammatory response syndrome（SIRS）（n = 34）,sepsis（n = 34）,severe sepsis（n = 34）,severe sepsis with shock（n = 34） and the healthy control without infection or fever（n = 34）.The concentrations of apo M,C-reactive protein（CRP）,procalcitonin（PCT）,total cholesterol（TC）,high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol（LDL-C）,apo AⅠ,apo B and lipoprotein（a） [Lp（a） ]in the sera were determined.The correlations of apo M concentration with other parameters in each group were analyzed.Results The apo M concentrations in serum were 11.20（9.13,13.16）,15.01（9.16,19.72）,3.21（2.27,4.57）,3.23（2.25,5.84） and 2.51（1.16,3.98） μg / mL（median [P 25,P 75 ]） in the group of control,infections unaccompanied by SIRS,severe sepsis and severe sepsis with shock,respectively.Compared with the control group or infections unaccompanied by SIRS,the concentration of apo M significantly decreased in the groups of sepsis,severe sepsis and the severe sepsis with shock（t = 9.70,9.26,11.52 and 0.57,10.12,12.39 respectively,all the P values were less than 0.01）.The apo M concentration in the group of severe sepsis with shock was significantly lower than that in the group of sepsis（t = 1.82,P 0.05） and severe sepsis（t =2.20,P 0.05）.The concentration of apo M in serum was negatively correlated with PCT concentration（r =-0.703,P = 0.000） during bacterial infection,and the area under the curve（AUC） of receiver operating characteristic（ROC） of apo M for diagnosing bacterial infection was 0.839（95% CI： 0.754 to 0.923）.Conclusion The decreased apo M level in serum may be used as a parameter for assessing the severity of infection.
出处
《临床检验杂志》
CAS
CSCD
北大核心
2013年第8期575-578,共4页
Chinese Journal of Clinical Laboratory Science
基金
湖南省自然科学基金(13JJ6093)
长沙市科技计划项目(K1207031-31)
关键词
细菌感染
降钙素原
C反应蛋白
载脂蛋白M
血脂
GUO Ling-xia, WANG Ling, ZHOU Hou-gang, HU Min （ Department of Clinical Laboratory, the Second Xiangya Hospital, CentralSouth University, Changsha 410011, Hunan , China）
