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Observation of Plasma Proendothelin-1 in 135 Patientswith SepsisChang-xing Guo, Zhao-fen Lin, MORGENTHALER NILS G, KOHRLE JOSEF,Xing-yi Yang, Liang Zhao, Hong-wei Shan, Yong-hua Xu, Qiang ZhangEmergency Department, Changzheng Hospital, Second Military Medical University, Shanghai 200003, ChinaSummaryBackground: To evaluate the significance of proendothelin-1 (proET-1) in the diagnosis of patients with sepsis (bacterial infection), we determinedplasma ProET-1 levels in 135 patients with sepsis in the ICU of Shanghai Changzheng Hospital from January 2006 to June 2007.Methods: Venous blood was collected from patients’ duringa 14 day period depending on the clinical condition. The blood specimens werecentrifuged and stored at -20℃. Sandwich ELISA was used to determine the proET-1 concentration in the plasma. All patients were divided into threegroups (healing group, improved group, unimproved group) according to the clinical response. The data were processed with SPSS13.0 software. Therelationship between proET-1 and clinical efficacy or infection score was analyzed.Results: The results showed that proET-1 levels of the unimproved group were significantly higher than those of the healing group (p
Cover Thesisbetween proET-1 and sepsis. With this approach we couldtest whether proET-1 content in plasma can be used asa reliable diagnostic marker which may help in the earlydiagnosis of the sepsis.MATERIALS AND METHODSSubjectsFrom January 2006 to June 2007, 135 cases wereadmitted to the ICU in Changzheng hospital including100 males and 35 females with the average age of 63.35±16.33 (17-80 years old). All the patients met the clinicaldiagnostic criteria for sepsis according to the followingcriteria: (1) histological, microbiological, and/or grossconfirmation of infection, and (2) systemic illnesscaused by infection and had a positive blood culture of apathogenic microorganism.MethodsThe collection of venous blood was taken once aday from the first day to the third day after admission.Beginning on the fourth day, venous blood was taken onceevery two days; 3-9 venous blood collections were takenfrom the patients depending on each patient’s condition.The observation time was 14 days if the patient survivedduring this stage. All the blood samples were centrifugedand stored at -20℃. A sandwich ELISA method wasused (provided by BRAHMS, Germany) to determineTable 1 Patients’ characteristics at enrolment.Group Number of patients (M/F) Mean Age (yrs)Healing group 95 (67/28) 61.8597 ±16.51840Effective and improved group 7 (4/3) 61.0000 ±14.32946Unimproved group 33 (28/5) 67.7513 ±14.61004Table 2 ProET-1 content in three groups (nmol/L).Group Mean N Std. Deviation VariationHealing group 64.4094 730 64.54917 4166.595Effective and improved group 70.0849 43 135.70907 18416.951Unimproved group 100.9884 194 81.70403 6675.548Total 72.0002 967 74.10321 5491.286Table 3 The comparison of proET-1 in different groups.ProET1GroupChi-Square (a,b) 285.425 802.983df 654 2Asymp. Sig. 1.000 .000a. 655 cells (100.0%) have expected frequencies less than 5. The minimum expected cell frequency is 1.5.b. 0 cells (0%) have expected frequencies less than 5. The minimum expected cell frequency is 325.7.the proET-1 level in the plasma. Other specimens frompatients (such as sputum, etc) were collected for localsecretion culture and routine blood test.The criteria of treatment efficacyAccording to the principles of clinical antibioticsstudy: (1) Healing: four criteria, including the symptoms,signs, laboratory tests, and bacteriological examinationof the patient recovered to the normal. (2) Effective:significant improvement of the disease, but one of fourcriteria was not completely back to normal. (3) Improved:condition improved after treatment, but not significantly.(4) Unimproved: all symptoms, physical signs of thepatients at the time of enrollment were maintained orworsened after 3 days of treatment.Statistical methodAll the data were processed by SPSS 13.0 software. Therelation between the level of proET-1, and clinical data(clinical efficacy and infection score) was analyzed.RESULTSAccording to the clinical response, 135 cases weredivided into three groups: healing group (95 cases),effective and improved group (7 cases), and unimprovedTable 4 The correlation between proET-1 content and clinicalefficacy.proET1 groupCorrelation Coefficient 1.000 0.175**proET-1 Sig. (2-tailed) 0.000Spearman's rhoN 967 967Correlation Coefficient 0.175** 1.000group Sig. (2-tailed) 0.000N 967 977** Correlation is significant at the 0.01 level (2-tailed).Table 5 Infection score varies in three groups.Group Mean N Std. Deviation Std. Error of MeanHealing group 9.6385 733 5.36600 0.19820Effective and improved group 10.6000 45 4.63877 0.69151Unimproved group 14.5816 196 7.32320 0.52309Total 10.6776 974 6.10467 0.19561** Correlation is significant at the 0.01 level (2-tailed).Table 6 The comparison of infection score in three groups.Infection ScoreGroupChi-Square(a,b) 802.807 802.983df 34 2Asymp. Sig. .000 .000a. 0 cells (0%) have expected frequencies less than 5. The minimum expected cell frequency is 27.8.b. 0 cells (0%) have expected frequencies less than 5. The minimum expected cell frequency is 325.7.Laboratory and Clinical Investigation Cover Thesis 19 FAM 2013 Jan/Feb Vol.20 Issue 1
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