Endothelial cell rescue therapy of multiorgan failure after severe sepsis

严重脓毒症后多器官衰竭的内皮细胞挽救治疗

基本信息

批准号：
22390337
负责人：
ISOTANI Eiji
金额：
$ 5.41万
依托单位：
Tokyo Women's Medical University (2011-2012)Tokyo Medical and Dental University (2010)
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2010
资助国家：
日本
起止时间：
2010 至 2012
项目状态：
已结题

项目摘要

Introduction: It is expected that recombinant human soluble thrombomodulin (rTM) not only reverses hyper-coagulative status through activating protein C but also prevents multiple organ failure. rTM may improve both physiological scores and the amount of mediators, and reduces the mortality of sepsis and DIC patients in 28 days. We started a new protocol by adding rTM for sepsis and disseminated intravascular coagulation patients. We introduce the preliminary report in this paper.Material & Methods: We enrolled and analyzed 21 patients who were treated for DIC accompanied by sepsis from May to October 2008. Our primary endpoint was mortality in 28 days. As composite outcomes, we followed Acute Physiology and Chronic Health Evaluation (APATCHE II) score, Sequential Organ Failure Assessment (SOFA) score, acute phase DIC score, and serum soluble thrombomodulin, TNF-α, IL-1β, IL-6, HMGB-1, protein C, protein S levels during 10 days. Statistical analysis was performed by Wilcoxon rank-sum test. P < 0.05 was regarded as statistically significant.Results: We found that all scores and mediators improved after administration of rTM in Day 10, but there was no significant improvement in at 28 days. Median of each score or mortality was as follows; APATCH II score: 32 at Day 1 to 26 at Day 10 (p=0.0048), SOFA score: 12 to 8 (p=0.0096), acute phase DIC score: 5 to 3 (p

简介：预计重组人可溶性血栓调节蛋白（rTM）不仅可以通过激活蛋白C逆转高凝状态，还可以预防多器官衰竭，改善生理评分和介质数量，并降低脓毒症和糖尿病的死亡率。我们在 28 天内开始了针对脓毒症和弥散性血管内凝血患者添加 rTM 的新方案。我们在本文中介绍了初步报告。材料和方法：我们招募并分析了 2008 年 5 月至 10 月期间因 DIC 并发脓毒症接受治疗的 21 名患者。我们的主要终点是 28 天内的死亡率，作为综合结果，我们跟踪了急性生理学和慢性健康评估 (APATCHE II) 评分、序贯性器官衰竭。评估（SOFA）评分、急性期DIC评分、血清可溶性血栓调节蛋白、TNF-α、IL-1β、IL-6、HMGB-1、蛋白C、蛋白S通过 Wilcoxon 秩和检验进行统计分析，P < 0.05 被认为具有统计学显着性。结果：我们发现在第 10 天施用 rTM 后，所有分数和中介指标均有所改善，但没有显着改善。第 28 天时每个评分或死亡率的中位数如下：第 1 天至第 10 天的 32（p=0.0048），SOFA评分：12 至 8 (p=0.0096)，急性期 DIC 评分：5 至 3 (p=0.0096)