危重症患者血浆活性ghrelin水平的变化及临床意义.DOC

PAGE 3 血浆活性ghrelin水平在ICU患者病情严重程度评估中的价值 陈晓东，陈庆伟，王 丽 （400010重庆，重庆医科大学附属第二医院老年医学科） 【摘要】 目的 探讨危重症患者的血浆活性生长激素促分泌物受体的内源性配体（ghrelin）水平的变化及其临床价值。方法 选择ICU危重症患者127名，另选30名健康体检者为对照组。应用酶联免疫吸附试验测定血浆活性ghrelin、TNF-α、IL-6水平，同时记录患者生理指标、实验室检查等临床数据。结果 危重症患者血浆活性ghrelin水平高于健康对照组(P 0．01）；根据急性生理及慢性健康状况评分（APACHE Ⅱ）≥15分及 15分将患者分为高危组及低危组后，高危组患者血浆活性ghrelin水平高于低危组（P 0．05）；危重症患者血浆活性ghrelin水平与体质量指数（BMI）呈负相关（r=－0.348，P 0．05)，与TNF-α、IL-6呈正相关（r=0.375，P 0．05；r=0.562，P 0．01)。多元线性逐步回归分析提示IL-6是影响血浆活性ghrelin水平的独立相关因素。结论 活性ghrelin在危重症患者外周血中高表达，可能与危重症状态下营养不良及高炎性反应有关，其测定可能有助于病情严重程度的评估。 【关键字】危重症；ghrelin；TNF-α、IL-6 【中图分类号】R446 【文献标志码】 A 【基金项目】国家自然科学基金 【通信作者】陈庆伟,E-mail： chenqwcq@ The value of plasma active ghrelin levels for the assessment of the severity of illness of ICU patients Chen Xiaodong ，Chen Qingwei，Wang Li (Department of Geriatric Medicine the second affiliated hospital, Chongqing medical university, Chongqing 400010, China) 【Abstract】Objective To investigate the changes of plasma growth hormone secretions receptor endogenous ligand (ghrelin) in the critically ill patients, and its clinical value. Methods plasma active ghrelin，TNF-α, IL-6 levels of 127 cases of critically ill patients and 30 healthy were measured by enzyme-linke immunosorbent assay， and the patients physiological indicators, laboratory tests were recorded at the same time.. Results （1）Critically ill patients plasma active ghrelin levels were significantly higher than the healthy control group (P 0.01) (2) According to the APACHE Ⅱ score≥ 15 and 15 ,patients were divided into high-risk group and low-risk groups; active ghrelin levels of the high-risk group were higher than the low-risk group (P 0.05); (3) In critically ill patients, plasma active ghrelin levels and body mass index (BMI) was negatively correlated (r = -0.348, P 0.05); with TNF-α, IL-6 was positively correlation (r = 0.375, P 0.05; r = 0.562, P 0.01). Multiple linear regression analysis prompted IL-6 levels were plasma active ghrelin independent