sVCAM-1与新型冠状病毒感染(COVID-19)重症病程相关的内皮功能障碍标志物

IF 0.3 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Rational Pharmacotherapy in Cardiology Pub Date : 2023-04-28 DOI:10.20996/1819-6446-2023-03-08
V. Podzolkov, A. Pokrovskaya, D. D. Vanina, I. I. Shvedov
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引用次数: 0

摘要

的目标。目的探讨内皮功能障碍标志物sVCAM-1水平与COVID-19重症病程的关系。材料和方法。本研究纳入100例COVID-19患者,根据CT结果根据肺损伤程度分为3组:CT 1 - 29组、CT 2 - 61组和CT 3 - 10组。除冠状病毒感染的标准检查外,所有患者均行颈动脉多普勒超声检查,使用VaSera装置分析动脉僵硬指数(CAVI, ABI),并通过elisa评估血浆sVCAM-1浓度。等离子体sVCAM-1浓度明显高于中度患者组的严重(CT 2)和严重(CT 3)患者肺部病变比轻度病变(CT - 1)。在一般组患者显著的相关性被发现之间的等离子体sVCAM-1浓度和血氧饱和度水平(r = -0.39, p = 0.032),医院住院时间(r = 0.24, p = 0.026), c反应蛋白的值(r = 0.25, p = 0.042),铁蛋白(r = 0.38, p = 0.021), LDH (r = 0.52, p = 0.015),入院时(r=0.41, p=0.019)和出院当天(r=0.35, p=0.022) CT资料肺部受累百分比。多因素回归分析显示,sVCAM-1与性别、年龄、体重指数(BMI)、是否存在2型糖尿病(T2DM)和高血压无关,是与细胞因子风暴进展、CT数据显示的中间负动态和呼吸支持需求相关的标志物。2型糖尿病的存在以及sVCAM-1浓度升高与高剂量糖皮质激素治疗的风险增加有关。针对上述每个事件计算了该标记的阈值水平。我们发现,在普通组患者中,sVCAM-1浓度与颈动脉内膜内侧厚度之间存在相关性(r=0.25, p=0.036)。血浆sVCAM-1浓度升高反映了内皮功能障碍的进展,这是COVID-19发病的关键因素之一。后者需要对这些患者进行内皮保护治疗。血浆中sVCAM-1的检测是一种很有前景的诊断技术,旨在预测COVID-19严重病程的风险及其长期健康危害。
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sVCAM-1 as a Marker of Endothelial Dysfunction associated with Severe Course of a Novel Coronavirus Infection (COVID-19)
Aim. To study the association of the level of endothelial dysfunction marker sVCAM-1 with the severe course of COVID-19.Material and methods. The study included 100 patients with COVID-19, who were divided into 3 groups depending on the degree of lung damage based on the results of computed tomography (CT): group CT 1 – 29 patients, group CT 2 – 61 patients and the group CT 3 – 10 patients. In addition to the standard examination performed for coronavirus infection, all patients underwent carotid Doppler ultrasound, analysis of arterial stiffness indices (CAVI, ABI) using the VaSera device, and evaluation of the plasma sVCAM-1 concentration by ELISA.Results. The plasma sVCAM-1 concentration was significantly higher in the groups of patients with moderately severe (CT 2) and severe (CT 3) lung lesions than in patients with mild lesions (CT 1). In the general group of patients significant correlations were found between the plasma sVCAM-1 concentration and the level of oxygen saturation (r=-0.39, p=0.032), hospital length of stay (r=0.24, p=0.026), values of C-reactive protein (r=0.25, p=0.042), ferritin (r=0.38, p=0.021), LDH (r=0.52, p=0.015) , as well as the percentage of pulmonary involvement according to CT data at admission (r=0.41, p=0.019) and on the day of discharge (r=0.35, p=0.022). According to multivariate regression analysis, sVCAM-1 does not depend upon gender, age, body mass index (BMI), the presence of type 2 diabetes mellitus (T2DM) and hypertension, and is a marker associated with cytokine storm progression, intermediate negative dynamics according to CT data, and need for respiratory support. The presence of type 2 diabetes, as well as elevated sVCAM-1 concentrations, is associated with an increased risk of high-dose glucocorticosteroid therapy. The threshold levels of this marker were calculated for each of the above events. We revealed a correlation between the sVCAM-1 concentration and the carotid intimal medial thickness in the general group of patients (r=0.25, p=0.036).Conclusion. An increase in the plasma sVCAM-1 concentration reflects the progression of endothelial dysfunction, one of the key factors in the pathogenesis of COVID-19. The latter necessitates the need for endothelium protective therapy for these patients. The evaluation of sVCAM-1 in blood plasma is a promising diagnostic technique aimed at predicting the risk of a severe course of COVID-19 and its long-term health hazards. 
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来源期刊
Rational Pharmacotherapy in Cardiology
Rational Pharmacotherapy in Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
1.00
自引率
50.00%
发文量
79
审稿时长
6 weeks
期刊介绍: The primary goals of the Journal are consolidation of information on scientific and practical achievements in pharmacotherapy and prevention of cardiovascular diseases and continuing education of cardiologists and internists. The scientific concept of the edition suggests the publication of information on current achievements in cardiology, the results of national and international clinical trials. The Journal publishes original articles on the results of clinical trials designed to study the effectiveness and safety of drugs, analysis of clinical practice and its compliance with national and international recommendations, expert s’ opinions on a wide range of cardiology issues, associated conditions and clinical pharmacology. There is a heading “Preventive cardiology and public health” in the Journal to stimulate research interest in this highly demanded area. Memories of the outstanding people in medicine including cardiology, which are of great interest to historians of medicine, are published in "Our Mentors” heading.
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