重症感染性休克患者治疗前后血清血管粘附蛋白.doc

宋根红，男，陕西人，（1977-），医学本科，主治医师，延安大学附属医院重症医学科。研究方向：各种危重症患者的治疗。邮箱：songgenhong1977@. 通讯地址： 陕西省延安市宝塔区北大街43号，邮编716000。 感染性休克患者治疗前后血清血管粘附蛋白-1及血浆多配体 蛋白聚糖-1水平变化 宋根红 延安大学附属医院重症医学科 陕西 延安 邮编716000 【摘要】 目的：研究感染性休克患者治疗前后血清血管粘附蛋白-1（VAP-1）及血浆多配体蛋白聚糖-1 (SDC-1)变化及其临床意义。 方法：收集2013年9月-2014年6月我院重症监护病房感染性休克患者50例的临床资料为观察组，同期选择50例本院体检中心健康体检人为对照组，分别于治疗前及治疗后第1、3、5天采取静脉血比较VAP-1及SDC-1水平变化，同时比较观察组生存患者和死亡患者入院第1天时血清VAP-1及血浆SDC-1水平差异及APACHEⅡ评分。结果：与对照组比较，感染性休克患者治疗前及治疗第后1、3、5天血清VAP-1及血浆SDC-1水平明显升高（P＜0.05），感染性休克组的VAP-1及SDC-1水平在治疗后第1、3天升高，治疗后第5天明显低于第3天（P＜0.05）；观察组中35例生存患者在入院第1天血清VAP-1、血浆SDC-1水平及APACHEⅡ评分明显低于15例死亡患者（P＜0.05）。结论：早期联合检测VAP-1及SDC-1变化有助于判断感染性休克患者病情严重程度及预后。 【关键词】：感染性休克；血管粘附蛋白-1；多配体蛋白聚糖-1 Serum Vascular Adhesion Protein-1 and Plasma Syndecan-1 Levels Before and After Treatment in Patients with Septic Shock Song Genhong Department of Intensive Care Unit, Hospital of Yanan University，ShanXi Yanan，716000 Abstract Objective：The purpose of this study was to investigate the serum vascular adhesion protein-1 (VAP-1) and syndecan-1 (SDC-1) levels before and after treatment in patients with severe septic shock. Methods：The clinical data of 50 patients with septic shock in the ICU in the hospital from September 2013 to June 2014 were collected for this study as observation group, 50 healthy adults in our hospital physical examination center as control group. The serum levels of VAP-1 and plasma SDC-1 were compared before and after treatment on days 1, 3 and 5. At the same time, the differences of serum VAP-1, plasma SDC-1 levels and APACHE II scores on admission were compared between survivors and non-survivors in observation group. Results: The serum level of VAP-1 and plasma SDC-1 levels were significantly higher in septic shock group than control group before treatment and after treatment on days 1, 3 and 5 (P＜0.05). In septic shock group, the serum level of VAP-1 and plasma SDC-1 levels were increased gradually after treatment in the 1st day and the 3rd day, and significantly lower on day 5 compare