Clinical Study Of VEGF And SFLT-1in Serum Of Paitents With Sepsis

ObjectiveWe investigated the changes of VEGF,sFLT-1and activity indices of VEGF in serum inpatients with sepsis, then the clinical significance to diagnosis and prognosis wasanalyzed.Methods66patients who meet the diagnosis of sepsis were studied after admitted to theemergency of First Affiliated Hospital of Anhui Medical University from March2010~October2010,and20healthy people from the medical examination center of FirstAffiliated Hospital of Anhui Medical University were selected for comparison.Patientswith sepsis were divided into sepsis group,severe sepsis group and MODS groupaccording to the severity of illness,and were divided into the survival group and thedeath group according to the survival status at28days.Serum was assayed for VEGFand sFLT-1by ELISA in patients with sepsis and those without it,furthermore,activityindices of VEGF were calculated. Next,we created a Spearman-rank correlation matrixshowing the association with each of the markers with APACHEII.Finally,to determinethe diagnostic and predictive accuracy of all the biomarkers,ROC curves wereconstructed,and AUCs were calculated.We used SPSS17.0package for data processing.Results1. In sepsis group,the VEGF,sFLT-1levels in serum were elevated significantlycompared with those in the control group (P<0.05); 2. The VEGF and sFLT levels in serum in severe sepsis group and MODS group wereelevated significantly compared with those in sepsis group (P<0.05),and in severe sepsisgroup the activity indices of VEGF were elevated significantly compared with those insepsis group and MODS group(P<0.05);3. In death group,the VEGF, sFLT-1levels and activity indices of VEGF in serum wereelevated significantly compared with those in the control group (P<0.05);4. In sepsis patients,the VEGF and sFLT-1levels and activity indices of VEGF in serumwere significantly associated with the APACHE-II score;5. The AUCs of serum levels of VEGF,sFLT-1and activity indices of VEGF in serumdiagnosing sepsis were0.763,0.764and0.581,respectively;6. The AUCs of serum levels of VEGF,sFLT-1and activity indices of VEGF inserum predicting28-day mortality of sepsis were0.912,0.862and0.855,respectively.Conclusions1. The VEGF and sFLT levels in serum and the activity indices of VEGF weresignificantly positive associated with the severity of illness;2. The VEGF and sFLT levels in serumcould be useful biomarkers for the diagnosis ofsepsis,furthermore,VEGF had a better sensitivity and sFLT-1had a better specificity,butthe activity indices of VEGF could not predict sepsis.3. The VEGF and sFLT levels in serum and the activity indices of VEGF could predictthe prognosis of sepsis.