The Correlation Between Cell-free DNA Level Of Neutrophils Extracellular Traps Markers And Platelet Activation In Sepsis:A Clinical Study

Objective: To study the correlation between cell-free DNA(cfDNA)levels of neutrophils extracellular traps(NETs)markers and platelet activation.Methods: According to inclusion criteria and exclusion criteria,patients were divided into non-sepsis group and sepsis group,who were admitted to the Intensive Care Unit(ICU)of the First Hospital of China Medical University from September 2018 to December 2018.Within 24 hours of entering the ICU,standardized items were tested,and peripheral blood samples were retained at the same time.Concentrations of cfDNA,PF4 and P selectin were detected by ELISA.SPSS 25.0 was used for statistical analysis.The biochemical indicators,cfDNA and platelet markers(PF4,P-selectin),acute physiology and chronic health evaluation ?(APACHE ?),sequential organ failure score(SOFA),ISTH score ect,were compared between the two groups within 24 hours of ICU admission.The Correlation analysis was performed between cfDNA and platelets,platelet markers(PF4,P-selectin),inflammatory markers(neutrophil count,CRP,PCT),coagulation indicators(PT,APTT,D dimer,AT III),disease severity(APACHE II,SOFA score,ISTH score,JAAM)in the sepsis group.Results: According to the inclusion and exclusion criteria,there were 29 patients in the sepsis group and 22 patients in the non-sepsis group.Compared with the non-sepsis group,cfDNA level of sepsis patients was significantly increased,but there was no significant statistical difference in P-selectin and PF4 levels between the two groups.There are correlation between cfDNA and the P-selectin/PLT,D2 polymers,c-reactive protein,APACHE ?,JAAM in sepsis group(P < 0.05).However,it was not significantly correlated with neutrophil count,platelet count,platelet markers(PF4,P-selectin),ISTH score etc.(P>0.05).Conclusion: Compared with the non-sepsis group,cfDNA in the sepsis group was significantly elevated,suggesting that NETs were produced during sepsis.There is a significant positive correlation between cfDNA and D-dimer in the sepsis group,and NETs may be closely related to the fibrinolysis process.Although there is a positive correlation between cfDNA and P-selectin / PLT in the sepsis group,because P-selectin cannot be used as a specific platelet activation marker,the relationship between NETs and sepsis platelet activation may be insufficient.