自噬相关蛋白在脓毒症并发急性呼吸窘迫综合征患者中的水平变化及临床意义  

Changes and clinical significance of autophagy⁃related protein in sepsis patients complicated with ARDS

作　　者：何子纯 张佳怡 HE Zichun;ZHANG Jiayi(Department of Pulmonary Medicine,the Red Cross Hospital of Chongqing,Jiangbei Dis-trict People′s Hospital of Chongqing,Chongqing 400020,China)

机构地区：[1]重庆市红十字会医院(江北区人民医院)呼吸内科,重庆400020

出　　处：《实用医学杂志》2021年第9期1131-1135,共5页The Journal of Practical Medicine

基　　金：国家科技支撑计划课题项目(编号:2015BAI01B14-19)。

摘　　要：目的研究自噬相关蛋白在脓毒症并发急性呼吸窘迫综合征(ARDS)患者中的表达及临床意义。方法采用q RT-PCR、蛋白免疫印迹法检测各组单个核细胞(PBMCs)中自噬相关因子(Beclin-1、LC3-Ⅱ、p62)的mRNA及蛋白表达;酶联免疫吸附法检测相关细胞因子(IL-1β、TNF-α、IL-6、IL-10)水平,分别比较各组上述指标的差异,评价自噬相关蛋白对脓毒症并发ARDS患者预后的评估价值。结果与非ARDS组比较,ARDS组PBMCs中Beclin-1、LC3-II mRNA及蛋白表达和外周血IL-10水平显著降低,而p62 mRNA及蛋白表达和外周血IL-1β、TNF-α及IL-6水平显著升高(P <0.05)。与存活组比较,死亡组PBMCs中Beclin-1、LC3-II mRNA及蛋白表达和外周血IL-10水平显著降低,而p62 mRNA及蛋白表达和外周血IL-1β、TNF-α及IL-6水平显著升高(P <0.05)。ARDS组患者Beclin-1和LC3-II mRNA分别与外周血IL-1β和TNF-α水平呈负相关;而p62 mRNA与外周血IL-1β和TNF-α水平呈正相关。ROC曲线分析表明,Beclin-1 mRNA、LC3-IImRNA和p62 mRNA区分存活和非存活患者的曲线下面积(AUC)分别为0.818(95%CI:0.743~0.913)、0.829(95%CI:0.738~0.921)和0.794(95%CI:0.705~0.883),其敏感性分别为75.96%、81.82%和71.19%,特异性分别为80.49%、75.61%和71.23%。结论自噬水平的降低参与了脓毒症并发ARDS的发生及发展,检测自噬水平对患者预后的评估具有一定临床价值。Objective To study the expression and clinical significance of autophagy⁃related proteins in sepsis patients with acute respiratory distress syndrome(ARDS).Methods The mRNA and protein expression levels of autophagy⁃related factors(Beclin⁃1,LC3⁃II,p62)in each group of mononuclear cells(PBMCs)were detected by qRT⁃PCR and western blotting;The related cytokines(IL⁃1β,TNF⁃α,IL⁃6,IL⁃10)levels were measured by enzyme⁃linked immunosorbent assay(ELISA).The differences of the above indicators in each group were compared and the prognostic value of autophagy⁃related proteins in sepsis patients with ARDS was evaluated.Results Compared with the non⁃ARDS group,the mRNA and protein expression levels of Beclin⁃1 and LC3⁃II in the PBMCs,and IL⁃10 in peripheral blood of ARDS group were significantly reduced,while the mRNA and pro⁃tein expression levels of p62,the IL⁃1β,TNF⁃αand IL⁃6 levels in peripheral blood were increased(P<0.05).Compared with the survival group,the mRNA and protein expression levels of Beclin⁃1 and LC3⁃II in the PBMCs,and IL⁃10 in peripheral blood of ARDS group were significantly reduced,while the mRNA and protein expression levels of p62,the IL⁃1β,TNF⁃αand IL⁃6 levels in peripheral blood were increased(P<0.05).In ARDS group,Beclin⁃1 and LC3⁃II mRNA were significantly negatively correlated with peripheral blood IL⁃1βand TNF⁃αlevels,respectively;while p62 mRNA was significantly positively correlated with peripheral blood IL⁃1βand TNF⁃αlevels.ROC curve analysis showed that the AUCs of Beclin⁃1 mRNA,LC3⁃II mRNA and p62 mRNA to distinguish surviving and non⁃surviving patients were 0.818(95%CI,0.743~0.913),0.829(95%CI,0.738~0.921),and 0.794(95%CI,0.705~0.883),respectively.Those sensitivity was 75.96%,81.82%and 71.19%;the specificity was 80.49%,75.61%and 71.23%,respectively.Conclusion The reduction of autophagy was involved in the occurrence and development ofsepsis complicated with ARDS.It has certain clinical value for the evaluation of

关 键 词：自噬相关蛋白 脓毒症 急性呼吸窘迫综合征 肿瘤坏死因子-α 预后 

分 类 号：R563[医药卫生—呼吸系统]