【摘要】 目的观察脓毒症患者血浆血管生成素2(Ang-2)和(1,3)-β-D-葡聚糖(BG)水平变化,并分析二者的关系。方法选择66例脓毒症患者,其中深部真菌感染11例(A组)、二重感染(G-杆菌合并真菌感染)36例(B组)、G-杆菌感染19例(C组),另选20例健康体检者为对照(D组)。24 h内进行急性生理和慢性健康状况(APACHEⅡ)评分、序贯器官衰竭(SOFA)评分,检测血浆Ang-2、BG。结果脓毒症各组血浆Ang-2均高于D组(P均<0.05),而脓毒症各组间血浆Ang-2差异无统计学意义(P均>0.05)。脓毒症各组血浆BG均高于D组(P均<0.05);A、B组血浆BG均高于C组(P均<0.05),而A、B组间差异无统计学意义(P>0.05)。脓毒症患者血浆Ang-2与APACHEⅡ、SOFA评分均呈正相关(r分别为0.599、0.723,P均<0.05),Ang-2与APACHEⅡ、SOFA评分均独立相关(β分别为0.468、0.626,P均<0.05)。除C组外脓毒症患者血浆Ang-2与BG呈正相关(r=0.371,P<0.05);血浆BG与Ang-2独立相关(β=0.393,P<0.05)。结论脓毒症患者血浆Ang-2、BG水平升高,Ang-2是影响脓毒症患者病情严重程度的独立危险因素,BG是影响真菌感染脓毒症患者血浆Ang-2水平的独立危险因素。更多还原

【Abstract】 Objective To investigate the plasma levels of angiopoietin-2( Ang-2),( 1,3)-β-D-glucan( BG) and their correlation in septic patients. Methods Sixty-six septic patients were divided into three groups: the deep fungal infection group( n = 11,group A),the double infection group caused by fungi and gram-negative bacteria( n = 36,group B) and the gram-negative bacteria infection group( n = 20,group C). The healthy volunteers were selected as the control group( n = 20,group D). The acute physiology and chronic health conditions( APACHE) Ⅱ score and sequential organ failure assessment( SOFA) score were recorded within 24 hours. Plasma Ang-2 and BG levels were detected. Results Plasma Ang-2 levels were significantly higher in the three septic groups than that in the group D( all P < 0. 05). There were no significant differences in the plasma levels of Ang-2 among these three septic groups( P > 0. 05). Plasma BG levels were all significantly higher in the three septic groups than that of group D( all P < 0. 05). The plasma BG levels in group A and group B were significantly higher than that of group C( P < 0. 05). There was no significant difference in plasma( 1,3)-β-D BG levels between group A and group B( P > 0. 05). The plasma Ang-2 level in septic patients was positively correlated with scores of APACHE Ⅱ and SOFA( r = 0. 599,P < 0. 05; r = 0. 723,P < 0. 05,respectively). The plasma Ang-2 level was independently correlated with the score of APACHE Ⅱ and SOFA in septic patients( β = 0. 468,P < 0. 05; β = 0. 626, P < 0. 001,respectively). The plasma Ang-2 level was positively correlated with plasma BG level in septic patients except group C( r = 0. 371,P < 0. 05). BG level was independently associated with Ang-2 level in septic patients( β = 0. 393,P< 0. 05). Conclusions Plasma Ang-2 and BG levels increase in septic patients. Ang-2 level is an independent risk factor which is associated with the severity of septic patients. BG is an independent risk factor which is associated with plasma Ang-2 level in septic patients with fungal infection.更多还原