Diagnostic value of platelet-leukocyte aggregates level in sepsis complicated with acute respiratory distress syndrome_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 JIANG Han , JIA Chao

Intensive Care Unit, Mianyang Central Hospital, Mianyang, Sichuan 621000, P. R. China;

Corresponding author：

JIANG Han, Email: 3486501@qq.com

Keywords：

Sepsis; Acute respiratory distress syndrome; Platelet-leukocyte aggregates

DOI：

10.7507/1671-6205.201705039

Video：

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ObjectiveTo investigate the changes of platelet-leukocyte aggregates (PLA) level in patients with sepsis and its diagnostic value in sepsis complicated with acute respiratory distress syndrome (ARDS).MethodsA prospective study was carried in adult sepsis patients admitted to our hospital from January 2015 to November 2016. According to the 2012 " Berlin definition” diagnostic criteria, 58 cases of sepsis with ARDS were allocated to an experimental group and 139 cases of sepsis non-ARDS patients were allocated to a control group. Immediately after the diagnosis of sepsis, elbow vein blood samples were collected for flow cytometry assay of PLA. The acute physiology and chronic health assessment II (APACHE II score) of each group was performed and the receiver operating characteristic (ROC) curve was drawn.ResultsPlatelet-neutrophil aggregates (PNA) and platelet-lymphocyte aggregates (PLyA) in the experimental group were higher than those in the control group, but there were no significant differences (both P>0.05). The platelet-monocyte aggregates (PMA) of the experimental group was significantly higher than that of the control group (P<0.05). Peripheral blood PMA was positively correlated with APACHE II score (r=0.671, P<0.001). When PMA was used as the test variable, the area under the curve (AUC) was 0.945 with significant diagnostic value (P<0.001), and optimal cutoff value of PMA was 8.25%, with diagnostic sensitivity of 0.806 and diagnostic specificity of 0.951. When APACHE II was used as the test variable, AUC was 0.930, with significant diagnostic value (P<0.001), and optimal threshold of APACHE II was 16.500 with diagnostic sensitivity of 0.871 and diagnostic specificity of 0.852.ConclusionPMA is of great value in the diagnosis of sepsis with ARDS.

Citation： JIANG Han, JIA Chao. Diagnostic value of platelet-leukocyte aggregates level in sepsis complicated with acute respiratory distress syndrome. Chinese Journal of Respiratory and Critical Care Medicine, 2018, 17(1): 42-45. doi: 10.7507/1671-6205.201705039 Copy

1.	槐永军, 张绍敏, 马壮, 等. 急性呼吸窘迫综合征预后的影响因素探讨. 临床军医杂志, 2010, 38(6): 943-945.
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12.	Ng CS, Wan S, Yim AP. Pulmonary dysfunction after cardiac surgery. Chest, 2002, 121(4): 1269-1277.
13.	Tao KY, An Q, Lin K, et al. Which is better to preserve pulmonary function: short-term or prolonged leukocyte depletion during cardiopulmonary bypass?. J Thorac Cardiovasc Surg, 2009, 138(6): 1385-1391.
14.	Rubenfeld GD, Herridge MS. Epidemiology and outcomes of acute lung injury. Chest, 2007, 131(2): 5554-5562.
15.	Johnson ER, Matthay MA. Acute lung injury: epidemiology, pathogenesis, and treatment. J Aerosol Med Pulm Drug Deliv. 2010, 23(4): 243-252.
16.	Fremont RD, Koyama T, Calfee CS, et al. Acute lung injury in patients with traumatic injuries: utility of a panel of biomarkers for diagnosis and pathogenesis. J Traumma, 2010: 68(5): 1121-1127.
17.	周静, 罗彤, 黎新建, 等. vWF 和 GMP-140 检测在心脏瓣膜置换术中变化的临床研究.四川医学, 2006, 27(5): 495-496.
18.	Cerletti C, Tamburrelli C, Izzi B, et al. Platelet-leukocyte interactions in thrombosis. Thromb Res, 2012, 129(3): 263-266.
19.	贾安奎, 刘彦轩, 张国林, 等.脓毒症患者外周血血小板-白细胞聚集体水平变化的意义. 中国急救医学, 2014, 34(4): 289-291.
20.	Rondina MT, Carlisle M, Fraughton T, et al. Platelet-monocyte aggregate formation and mortality risk in older patients with severe sepsis and septic shock. J Gerontol A Biol Sci Med Sci, 2015, 70(2)225-231.
21.	梅春霞. LBP 基因多态性、APACHEⅡ 评分和降钙素原对 ARDS 预警作用的初步研究（硕士论文）. 第三军医大学, 2014.

1. 槐永军, 张绍敏, 马壮, 等. 急性呼吸窘迫综合征预后的影响因素探讨. 临床军医杂志, 2010, 38(6): 943-945.
2. Ranieri VM, Rubenfeld GD, Thompson BT, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA, 2012, 307(23): 2526-2533.
3. Hardwav RM. A brief overview of acute respiratory distress syndrome .World Surg, 2006, 30(10): 1829.
4. 周永列. 血小板活化标志物及其临床意义. 国外医学临床生物化学与检验学分册, 2000, 21(6): 299-301.
5. Danese E, Montagnana M, Lippi G. Platelets and migraine. Thromb Res, 2014, 134(1): 17-22.
6. Ahn KC, Jun AJ, Pawar P, et al. Preferential binding of platelets to monocytes over neutrophils under flow. Biochem Biophys Res Commun, 2005, 329(1): 345-355.
7. Nagasawa A, Matsuno K, Tamura S, et al. The basis examination of leukocyte-platelet aggregates with CD45 gating as a novel platelet activation marker. Int J Lab Hematol, 2013, 35(5): 534-541.
8. Michelson AD, Barnard MR, Krueger LA, et al.Circulating monocyte-platelet aggregates are a more sensitive marker of in vivo platelet activation than platelet surface P-selectin.Circulation, 2001, 104(13): 1533-1537.
9. Hui H, Fuller K, Erber WN, et al. Measurement of monocyte-platelet aggregates by imaging flow cytometry. Cytometry A, 2015, 87(3): 273-278.
10. Jung BK, Cho CH, Moon KC, et al. Detection of platelet-monocyte aggregates by the ADAM® image cytometer. Int J Med Sci, 2014, 11(12): 1228-1233.
11. Takaoka Y, Goto S, Nakano T, et al. Glyceraldehyde-3-phosphate dehydrogenase (GAPDH) prevents lipopolysaccharide (LPS)-induced, sepsis-related severe acute lung injury in mice. Sci Rep, 2014, 4: 5204-5212.
12. Ng CS, Wan S, Yim AP. Pulmonary dysfunction after cardiac surgery. Chest, 2002, 121(4): 1269-1277.
13. Tao KY, An Q, Lin K, et al. Which is better to preserve pulmonary function: short-term or prolonged leukocyte depletion during cardiopulmonary bypass?. J Thorac Cardiovasc Surg, 2009, 138(6): 1385-1391.
14. Rubenfeld GD, Herridge MS. Epidemiology and outcomes of acute lung injury. Chest, 2007, 131(2): 5554-5562.
15. Johnson ER, Matthay MA. Acute lung injury: epidemiology, pathogenesis, and treatment. J Aerosol Med Pulm Drug Deliv. 2010, 23(4): 243-252.
16. Fremont RD, Koyama T, Calfee CS, et al. Acute lung injury in patients with traumatic injuries: utility of a panel of biomarkers for diagnosis and pathogenesis. J Traumma, 2010: 68(5): 1121-1127.
17. 周静, 罗彤, 黎新建, 等. vWF 和 GMP-140 检测在心脏瓣膜置换术中变化的临床研究.四川医学, 2006, 27(5): 495-496.
18. Cerletti C, Tamburrelli C, Izzi B, et al. Platelet-leukocyte interactions in thrombosis. Thromb Res, 2012, 129(3): 263-266.
19. 贾安奎, 刘彦轩, 张国林, 等.脓毒症患者外周血血小板-白细胞聚集体水平变化的意义. 中国急救医学, 2014, 34(4): 289-291.
20. Rondina MT, Carlisle M, Fraughton T, et al. Platelet-monocyte aggregate formation and mortality risk in older patients with severe sepsis and septic shock. J Gerontol A Biol Sci Med Sci, 2015, 70(2)225-231.
21. 梅春霞. LBP 基因多态性、APACHEⅡ 评分和降钙素原对 ARDS 预警作用的初步研究（硕士论文）. 第三军医大学, 2014.

Chinese Journal of Respiratory and Critical Care Medicine

Diagnostic value of platelet-leukocyte aggregates level in sepsis complicated with acute respiratory distress syndrome

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