Relationship between serum vascular endothelial cadherin level and prognosis of patients with septic shock / 中华急诊医学杂志

ABSTRACT

Objective To investigate the prognostic significance of serum VE-cadherin in patients with septic shock. Methods A prospective observation study was performed between January 2016 and December 2017, forty-eight septic shock patients from intensive care unit (ICU) were enrolled, and 25 healthy volunteers served as the controls. Meanwhile, patients in the septic shock group were divided into two subgroups of the survival and death groups according to the 28-day mortality. The dynamic value changes of serum VE-cadherin (VE-Cad), vascular endothelial growth factor (VEGF), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were monitored on the 1st, 3rd and 7th day after admission. Results The serum VE-Cad level of the septic group was significantly higher than that of the control group on the 1st day (3.02±0.18 ng/mL vs. 0.26±0.05 ng/mL, t=3.275, P=0.002). There was a positive correlation between VE-Cad level and VEGF, TNF-α and IL-6 (r=0.826, 0.723, and 0.870, respectively; P<0.01). The PaO2/FiO2 and serum albumin (ALB) level of the death group were lower than that of the survival group, and extravascular lung water index (EVLWI), serum lactate, mechanical ventilation time, 7 day fluid balance, APACHE Ⅱ and SOFA levels of the death group were higher than those of the survival group. The serum VE-Cad levels of the death group were higher than those of the survival group on the 1st, 3rd and 7th day. The serum VE-Cad levels were positively correlated with APACHE Ⅱ and SOFA. The area under the ROC curve of VE-Cad predicting septic shock death on day 1 was 0.723 (95％CI 0.568-0.878). The sensitivity and specificity of VE-Cad with cut-off of 3.1 ng/mL in predicting septic shock death were 60％ and 70.83％, respectively. Conclusions Serum VE-Cad is positively correlated with disease severity and could predict a poor outcome in septic shock patients.