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目的通过分析血管生成素2(angiogenin-2,Ang-2)/血管生成素1(angiogenin-1,Ang-1)、Ang-1/酪氨酸激酶2(tyrosine kinase-2,Tie-2)在脓毒症中的表达,了解其在脓毒症早期诊断、危险分层、预后中的价值,并将这些因素与降钙素原(procalcitonin,PCT)在早期脓毒症中比较。方法通过酶联免疫吸附剂测定(enzyme linked immunosorbent assay,ELISA)440例诊断为脓毒症患者(观察组)及55例健康者(对照组)血液中Ang-1、Ang-2、Tie-2及PCT表达水平,比较Ang-2/Ang-1、Ang-1/Tie-2、Ang-1、Ang-2、Tie-2与PCT的预后价值。所有患者均随访28d。结果 Ang-2中位水平和Ang-2/Ang-1比值升高、Ang-1水平及Ang-1/Tie-2比值下降提示脓毒症风险程度更加严重。Ang-2/Ang-1与Ang-1/Tie-2比值在诊断及28d随访致死率受试者工作特征曲线(receiver operating characteristic curve,ROC)中面积较Ang-1、Ang-2及PCT水平大。Ang-2/Ang-1比值大于1.94的患者较Ang-2/Ang-1患者预后较差;Ang-1/Tie-2比例低于0.03者生存率较其高的要低。Ang-2/Ang-1,Ang-1/Tie-2可作为脓毒症独立预后因素。Ang-1、Ang-2与Tie-2呈正相关。在每个分组中,Ang-2/Ang-1与脓毒症患者预后呈负相关,而Ang-1/Tie-2与急诊脓毒症预后呈正相关。结论 Ang-2/Ang-1、Ang-1/Tie-2与脓毒症危险分层相关,并可预测脓毒症预后不良。
OBJECTIVE: To investigate the effects of angiogenin-2 (Ang-2) / angiogenin-1 (Ang-1), Ang-1 / tyrosine kinase- In sepsis, to understand its value in the early diagnosis of sepsis, risk stratification, prognosis, and to compare these factors with procalcitonin (PCT) in early sepsis. Methods Serum levels of Ang-1, Ang-2 and Tie-2 in 440 patients with sepsis (observation group) and 55 healthy controls (control group) were detected by enzyme linked immunosorbent assay (ELISA) The expression of Ang-2 / Ang-1, Ang-1 / Tie-2, Ang-1, Ang-2, Tie-2 and PCT were compared. All patients were followed up for 28 days. Results The median level of Ang-2 and the ratio of Ang-2 / Ang-1 were increased. The decrease of Ang-1 level and Ang-1 / Tie-2 ratio suggested that the risk of sepsis was more serious. The ratio of Ang-2 / Ang-1 to Ang-1 / Tie-2 in the receiver operating characteristic curve (ROC) was higher than that of Ang-1, Ang-2 and PCT in the diagnostic and 28-day follow- Big. The prognosis of patients with Ang-2 / Ang-1 ratio greater than 1.94 was worse than that of Ang-2 / Ang-1 patients. The survival rate of patients with Ang-2 / Ang-2 ratio less than 0.03 was lower than that of patients with Ang-2 / Ang- Ang-2 / Ang-1, Ang-1 / Tie-2 can be used as independent prognostic factors of sepsis. Ang-1, Ang-2 and Tie-2 were positively correlated. Ang-2 / Ang-1 was negatively correlated with the prognosis of patients with sepsis in each subgroup, whereas Ang-1 / Tie-2 was positively correlated with the prognosis of emergency sepsis. Conclusions Ang-2 / Ang-1 and Ang-1 / Tie-2 are associated with the risk stratification of sepsis and can predict the poor prognosis of sepsis.