We hypothesised that plasma concentrations of biomarkers of neutrophil activation and pro-inflammatory cytokines differ according to the phase of rapidly evolving sepsis. In an observational study, we measured heparin-binding protein (HBP), myeloperoxidase (MPO), IL-6 and IL-8 in 167 sepsis patients on intensive care unit admission. We prospectively used the emergence of the first sepsis-associated organ dysfunction (OD) as a surrogate for the sepsis phase. Fifty-five patients (of 167, 33%) developed the first OD > 1 h before, 74 (44%) within ± 1 h, and 38 (23%) > 1 h after intensive care unit admission. HBP and MPO were elevated at a median of 12 h before the first OD, remained high up to 24 h, and were not associated with sepsis phase. IL-6 and IL-8 rose and declined rapidly close to OD emergence. Elevation of neutrophil activation markers HBP and MPO was an early event in the evolution of sepsis, lasting beyond the subsidence of the pro-inflammatory cytokine reaction. Thus, as sepsis biomarkers, HBP and MPO were not as prone as IL-6 and IL-8 to the effect of sample timing.

我们假设中性粒细胞活化和促炎细胞因子的生物标志物的血浆浓度根据脓毒症迅速发展的阶段而有所不同。在一项观察性研究中，我们测量了 167 名进入重症监护室的脓毒症患者的肝素结合蛋白 (HBP)、髓过氧化物酶 (MPO)、IL-6 和 IL-8。我们前瞻性地使用第一个脓毒症相关器官功能障碍 (OD) 的出现作为脓毒症阶段的替代指标。55 名患者（167 名，33%）首次出现 OD > 1 小时前，74 名（44%）在 ±1 小时内出现，38 名（23%）在重症监护病房入院后 1 小时内出现。HBP 和 MPO 在第一次 OD 前 12 小时的中位值升高，一直保持到 24 小时，并且与脓毒症阶段无关。IL-6 和 IL-8 在接近 OD 出现时迅速上升和下降。中性粒细胞活化标志物 HBP 和 MPO 的升高是脓毒症演变的早期事件，持续时间超过促炎细胞因子反应的消退。因此，作为败血症生物标志物，HBP 和 MPO 不像 IL-6 和 IL-8 那样容易受到采样时间的影响。