Objective To investigate the plasma levels of soluble Fas receptor ( sFas) , soluble Fas ligand ( sFas-L) and matrix metalloproteinase-7 ( MMP-7) and their correlation with disease severity as well as the prognosis of septic patients.Methods The plasma levels of sFas, sFas-L, sFas / sFas-L ratio and MMP-7 were measured by enzyme-linked immunosorbent assay and compared between32 patients with sepsis and 24 age and sex matched healthy controls. Based on the 28-day outcome, the patients were divided into a survival group and a death group. The difference in sFas, sFas-L, sFas/ sFas-L ratio and MMP-7 between the survival group and the death group were compared.Results Compared with the healthy control group, the concentration of plasma sFas, sFas-L and MMP-7 were significantly increased in the septic patients ( P lt; 0. 01) . Elevated plasma sFas and sFas-L were both positive correlated with the APACHEⅡ score and SOFA score. Although a modest negative correlation was found between plasma MMP-7 and APACHEⅡ score and SOFA score, but this correlation did not reach statistical significance ( P gt;0. 05) . The septic patients who died had significantly higher sFas-L level and lower sFas / sFas-L ratio as compared with those who survived ( P lt;0. 05) . Conclusion Plasma sFas, sFas-L and MMP-7 are associated with the disease severity and can serve as potential markers for predicting the outcome in septic patients.
ObjectiveTo investigate the clinical value of serum proadrenomedullin (pro-ADM) for diagnosis of ventilator-associated pneumonia(VAP). MethodsA prospective study was carried out in eighty-nine patients with clinically suspected diagnosis of VAP who underwent invasive mechanical ventilation between June 2014 and July 2015.The patients were divided into a VAP group (n=52) and a non-VAP group (n=37) according to clinical and microbiological culture results.The levels of serum pro-ADM were measured by sandwich ELISA on 1st, 3rd and 5th day of VAP suspicion.The diagnostic value of pro-ADM for VAP was assessed by receiver operating characteristic (ROC) curve analysis. ResultsOn 1st day, 3rd day and 5th day, the pro-ADM levels [3.10(2.21, 4.61) nmol/L, 3.01(2.04, 4.75)nmol/L and 1.85(1.12, 3.54)nmol/L, respectively] in the VAP group were significantly higher than those in the non-VAP group [1.53(1.07, 2.24)nmol/L, 1.52(1.05, 2.17) nmol/L and 1.26(1.02, 2.17) nmol/L, respectively] (all P < 0.05).For diagnosis of VAP, the area under the ROC curve (AUC) for pro-ADM on 1st, 3rd and 5th were 0.896 (95%CI 0.799-0.940), 0.863(95%CI 0.791-0.935) and 0.651 (95%CI 0.538-0.765), respectively.When using 2.53 nmol/L as the best cutoff on 1st day, pro-ADM had 84.6% sensitivity and 86.5% specificity.When using 2.40 nmol/L as the best cutoff on 3rd day, pro-ADM had 82.7% sensitivity and 83.8% specificity. ConclusionSerum level of pro-ADM in the diagnosis of VAP has good sensitivity and specificity, which may be used as a marker to diagnose VAP early.