血浆游离线粒体DNA拷贝数与烧伤患者病情的相关性  

Correlation between the copy number of plasma free mitochondrial DNA and severity of burn patients

作　　者：顼小凤 王健祯 杨泽华[1] XU Xiaofeng;WANG Jianzhen;YANG Zehua(Laboratory of the First Hospital of Shanxi Medical University,Taiyuan 030001,Shanxi,China)

机构地区：[1]山西医科大学第一医院检验科,山西太原030001

出　　处：《山东大学学报（医学版）》2021年第11期61-66,83,共7页Journal of Shandong University:Health Sciences

摘　　要：目的探讨不同程度烧伤患者血浆游离线粒体DNA(mtDNA)拷贝数变化及在烧伤病情中的作用。方法根据患者烧伤程度、面积(TBSA)选取重度烧伤患者30例(重度烧伤组)及中度烧伤患者30例(中度烧伤组),纳入同期30名健康体检者(正常对照组)。采集所有参试者入院第1、8~11、18~21天的血浆标本。所有血浆标本经试剂盒提取DNA,通过实时荧光定量PCR法检测血浆游离mtDNA拷贝数。分析mtDNA拷贝数与急性生理学和慢性健康状况Ⅱ(APACHEⅡ)、多器官功能障碍综合征评分(MODS)、TBSA、Ⅲ°烧伤面积、烧伤指数及生化指标间相关性,并将上述指标进行Logistic回归分析。结果重度烧伤组入院第1天血浆游离mtDNA拷贝数高于中度烧伤组和正常对照组,重度烧伤组血浆游离mtDNA拷贝数在第8~11天到达峰值之后降低;mtDNA拷贝数与烧伤总面积、Ⅲ°烧伤面积、烧伤指数、APACHEⅡ评分、MODS呈正相关(P<0.05),与生化指标天冬氨酸氨基转移酶、谷丙氨酸氨基转移酶、总胆红素、降钙素原、白细胞呈正相关(P<0.01),与总蛋白、白蛋白及前白蛋白呈负相关(P<0.01);经Logistic回归分析显示,患者APACHEⅡ评分和住院当天mtDNA拷贝数为烧伤严重程度的独立危险因素(P<0.05);mtDNA拷贝数在诊断烧伤程度的ROC曲线下面积为0.904,敏感度为0.833,特异性为0.867。结论烧伤患者血浆游离mtDNA拷贝数与烧伤程度和多项生化指标具有相关性,为临床判断烧伤程度提供依据。Objective To investigate the changes of plasma free mitochondrial DNA(mtDNA) copy number in patients with different degrees of burns and its role in the severity of burns.Methods In accordance with the burn degree and total body surface area(TBSA),30 patients with severe burns and 30 patients with moderate burns were selected.Another 30 healthy subjects were enrolled as controls.Plasma samples were collected on day 1,days 8-11,and days 18-21.DNA was extracted,and the copy numbers of plasma free mtDNA were detected with real-time fluorescent quantitative PCR.The correlation among mtDNA copy number,acute physiology and chronic health evaluation Ⅱ score(APACHE Ⅱ),multiple organ dysfunction syndrome score(MODS),TBSA,Ⅲ° burn area,burn index and biochemical indicators were analyzed,and Logistic regression was conducted.Results On day 1 of admission,the severe burn group had higher copy number of plasma free mtDNA than the other two groups,and the free mtDNA copy number reached the peak on days 8-11 and then decreased.The copy number of mtDNA was positively correlated with total burn size,Ⅲ° burn area,burn index,APACHE Ⅱ score and MODS(P<0.05),positively correlated with biochemical indicators such as aspartate aminotransferase,alanine aminotransferase,total bilirubin,procalcitonin,and white blood cells(P<0.01),but negatively correlated with total protein,albumin and prealbumin(P<0.01).Logistic regression analysis showed that APACHE Ⅱ score and mtDNA copy number on day 1 of admission were independent risk factors for burn severity(P<0.05).The area under the ROC curve for the diagnosis of burn degree of mtDNA copy number was 0.904,with a sensitivity of 0.833 and a specificity of 0.867.Conclusion The copy number of plasma free mtDNA in burn patients is correlated with the degree of burn and a number of biochemical indexes,which can provide references for the clinical classification of degree of burn.

关 键 词：烧伤程度 游离线粒体DNA 实时荧光定量PCR 烧伤病情 生化指标 

分 类 号：R644[医药卫生—外科学]