Using angiogenic factors and their soluble receptors to predict organ dysfunction in patients with disseminated intravascular coagulation associated with severe trauma 英文参考文献.docVIP

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Using angiogenic factors and their soluble receptors to predict organ dysfunction in patients with disseminated intravascular coagulation associated with severe trauma 英文参考文献.doc

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Using angiogenic factors and their soluble receptors to predict organ dysfunction in patients with disseminated intravascular coagulation associated with severe trauma 英文参考文献

Wadaetal.CriticalCare2012,16:R63 /content/16/2/R63 RESEARCH OpenAccess Usingangiogenicfactorsandtheirsoluble receptorstopredictorgandysfunctioninpatients withdisseminatedintravascularcoagulation associatedwithseveretrauma TakeshiWada1,SubrinaJesmin1,2,3*,SatoshiGando1,SayeedaNSultana2,3,SohelZaedi2,3 andHiroyukiYokota4 Abstract Introduction:Disseminatedintravascularcoagulation(DIC)ischaracterizedbytheconcomitantactivationof coagulofibrinolyticdisordersandsystemicinflammationassociatedwithendothelialdysfunction-induced microvascularpermeability.Angiogenicfactors,includingvascularendothelialgrowthfactor(VEGF),angiopoietin (Ang),andtheirreceptors,playcrucialrolesinangiogenesisandmicrovascularpermeability.Theaimofthestudy wastoassesstherelationshipbetweenangiogenicfactors,theirsolublereceptorsandorgandysfunction associatedwithDICafterseveretrauma. Materialsandmethods:Atotalof57patientswithseveretraumaweredividedintotwosubgroups;30DIC patientsand27non-DICpatients.TheDICwasdiagnosedbasedontheJapaneseAssociationforAcuteMedicine (JAAM)DICandtheInternationalSocietyonThrombosisandHaemostasis(ISTH)overtDICcriteria.Theserumlevels ofangiogenicfactorsweremeasuredatthetimeofadmission(Day1),Day3andDay5.Thisstudycompared levelsoftheseangiogenicfactorsbetweenthetwoDICgroups,andevaluatedtheirpredictivevaluefororgan dysfunction. Results:DICpatients,especiallythosewithISTHDIC,showedhigherSequentialOrganFailureAssessment(SOFA) scoresandlactatelevels.TherewerelowerlevelsofVEGF,Ang1andthesolubleTie2intheISTHDICpatientsthan thenon-DICpatients.ThelevelsofsolubleVEGFreceptor-1(sVEGFR1),Ang2andtheAng2/Ang1ratiointheISTH DICpatientswerehigherthaninnon-DICpatients.Therelationshipbetweenthepresenceofmassivetransfusion andangiogenicfactorsindicatedthesameresults.ThelevelsofsVEGFR1,Ang2andtheAng2/Ang1ratiocorrelated withtheSOFAscores.Inparticular,sVEGFR1andAng2wereindependentpredictorsofanincreaseintheSOFA score.ThelactatelevelsindependentlypredictedincreasesinthelevelsofsVEGFR1andAng2.Thede