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Báo cáo y học: " The role of angiogenic factors in predicting clinical outcome in severe bacterial infection in Malawian children"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: The role of angiogenic factors in predicting clinical outcome in severe bacterial infection in Malawian children. | Mankhambo et al. Critical Care 2010 14 R91 http ccforum.eom content 14 3 R91 c CRITICAL CARE RESEARCH Open Access The role of angiogenic factors in predicting clinical outcome in severe bacterial infection in Malawian children Limangeni A Mankhambo 1 2 Daniel L Banda1 The IPD Study Group1 Graham Jeffers4 Sarah A White1 Paul Balmer3 Standwell Nkhoma1 Happy Phiri1 Elizabeth M Molyneux2 C Anthony Hart5 Malcolm E Molyneux1 Roberts Heyderman1 and Enitan DCarrol 1 4 Abstract Introduction Severe sepsis is a disease of the microcirculation with endothelial dysfunction playing a key role in its pathogenesis and subsequent associated mortality. Angiogenesis in damaged small vessels may ameliorate this dysfunction. The aim of the study was to determine whether the angiogenic factors vascular endothelial growth factor VEGF platelet-derived growth factor PDGF fibroblast growth factor FGF and angiopoietin-1 Ang-1 and -2 Ang-2 are mortality indicators in Malawian children with severe bacterial infection. Methods In 293 children with severe bacterial infection plasma VEGF PDGF FGF and Ang-1 and Ang-2 were measured on admission in 50 of the children with meningitis VEGF PDGF and FGF were also measured in the CSF. Healthy controls comprised children from some of the villages of the index cases. Univariable and multivariable logistic regression analyses were performed to develop a prognostic model. Results The median age was 2.4 years and the IQR 0.7 to 6.0 years. There were 211 children with bacterial meningitis 72 and 82 28 with pneumonia and 154 53 children were HIV infected. Mean VEGF PDGF and FGF concentrations were higher in survivors than in nonsurvivors but only PDGF remained significantly increased in multivariate analysis P 0.007 . Mean Ang-1 was significantly increased and Ang-2 was significantly decreased in survivors compared with nonsurvivors 6 000 versus 3 900 pg ml P 0.03 and 7 700 versus 11 900 pg ml P 0.02 respectively . With a logistic regression model and .