Prognostic significance of C5a2 on polymorphonuclear neutrophil and C5a2intra/C5a2 ratio level for early sepsis in an ED

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• 作者：Ying-ying Fang ; MD ^{fyy9923@sina.com" class="auth_mail" title="E-mail the corresponding author} ; Rui Shao ; MD ^{shaorui2222@163.com" class="auth_mail" title="E-mail the corresponding author} ; Han Yu ; MD ^{yuhan12212@126.com" class="auth_mail" title="E-mail the corresponding author} ; Qing Zhang ; MD ^{1084159372@qq.com" class="auth_mail" title="E-mail the corresponding author} ; Miao-miao Wang ; MD ^{wmm8933@sina.com" class="auth_mail" title="E-mail the corresponding author} ; Chun-sheng Li ; MD ; PhD ; ^{lcscyyy04@sina.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：C5a2 (Gpr77) ; the second C5a receptor ; PMNs ; polymorphonuclear neutrophils ; Neu ; neutrophils ; C5a2intra ; the expression of the second receptor of C5a in neutrophils ; ED ; emergency deparment ; SIRS ; systemic inflammatory response syndrome ; MEDS score ; Mortality in Emergency Department Sepsis score ; ROC curve ; receiver operating characteristic curve ; AUCs ; the areas under the receiver operating characteristic curves ; WBC ; white blood cells ; APACHE ; acute physiology and chronic health evaluation ; PC
• 刊名：The American Journal of Emergency Medicine
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：34
• 期：11
• 页码：2084-2089
• 全文大小：544 K

文摘

The current study was designed to evaluate the expression of the second C5a receptor (C5a2) on polymorphonuclear neutrophil and in the cytoplasm of polymorphonuclear neutrophils (C5a2intra) in patients with sepsis in the emergency department (ED) for risk stratification and mortality.

Methods

Consecutive patients fulfilling the criteria for systemic inflammatory response syndrome (n = 357) were admitted to Beijing Chao-Yang Hospital ED between January 2015 and July 2015. They were enrolled to identify the expression of C5a2 and C5a2intra and categorized into the following 4 groups: systemic inflammatory response syndrome, sepsis, severe sepsis, and septic shock.

Results

We report that the surface C5a2 decreased and the C5a2intra/C5a2 ratio level increased with sepsis severity. As independent predictors of 28-day mortality, the areas under the receiver operating characteristic curves of combination of C5a2 or C5a2intra/C5a2 ratio level and the Mortality in ED Sepsis score were significantly higher than that of procalcitonin alone in predicting 28-day mortality in septic patients.

Conclusion

The C5a2 and the C5a2intra/C5a2 ratio levels are probably valuable for the risk stratification of sepsis and are associated with the mortality of early sepsis in the ED.