HMGB1、lncRNA H19与脓毒症患者预后的关系  

The relationship between HMGB1, lncRNA H19 and the prognosis of sepsis patients

作　　者：唐雯[1] 巴音查汗·博然衣 张大权[1] 肖东[1] 刘艳[1] Tang Wen;Bayinchahan Boranyi;Zhang Daquan;Xiao Dong;Liu Yan(Department of Critical Care Medicine,People's Hospital of Xinjiang Uygur Autonomous Region,Xinjiang Province,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院重症医学科,乌鲁木齐830001

出　　处：《疑难病杂志》2023年第12期1251-1255,1267,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：新疆维吾尔自治区自然科学基金资助项目(2022D01C118)。

摘　　要：目的分析血清高迁移率族蛋白B1(HMGB1)、长链非编码RNA H19(lncRNA H19)与脓毒症患者预后的关系。方法选取2020年1月—2022年3月新疆维吾尔自治区人民医院重症医学科诊治的脓毒症患者128例为研究对象,根据其28 d临床结局分为生存组87例和死亡组41例。比较2组血清HMGB1、lncRNA H19水平。Logistic多因素回归分析脓毒症患者预后的影响因素;绘制受试者工作特征曲线(ROC)分析血清HMGB1、lncRNA H19评估患者预后的价值,并采用决策曲线分析(DCA)血清HMGB1、lncRNA H19单独与联合评估的临床获益率。结果死亡组血清HMGB1水平高于生存组,lncRNA H19水平低于生存组(t/P=5.212/<0.001,5.487/<0.001)。Logistic多因素回归分析结果显示,血清HMGB1升高是脓毒症患者预后的独立危险因素[OR(95%CI)=3.710(1.965~7.004)],血清lncRNA H19升高为其独立保护因素[OR(95%CI)=0.331(0.117~0.935)]。ROC曲线结果显示,血清HMGB1、lncRNA H19及二者联合评估脓毒症患者预后的曲线下面积(AUC)分别为0.760、0.788、0.867,二者联合评估预后价值大于单项预测(Z/P=3.245/<0.001、2.641/0.008)。绘制DCA曲线结果显示,在阈值0.23~0.73范围内,血清HMGB1、lncRNA H19联合评估模型评估脓毒症患者预后的净受益率优于单独检测。结论血清HMGB1升高、lncRNA H19降低可增加脓毒症患者28 d死亡风险,检测二者水平可用于患者预后评估,且联合评估可提高净受益率。Objective To analyze the relationship between serum high mobility group protein B1(HMGB1),long chain non coding RNA H19(lncRNA H19)and the prognosis of sepsis patients.Methods One hundred and twenty-eight patients with sepsis diagnosed and treated by the Department of Critical Care Medicine of Xinjiang Uygur Autonomous Region People's Hospital from January 2020 to March 2022 were selected as the study objects.According to their 28-day clinical outcomes,they were divided into 87 survival patients and 41 death patients.Serum HMGB1 and lncRNA H19 levels were compared between the two groups.Logistic multivariate regression analysis was used to analyze the factors influencing the prognosis of sepsis patients.The ROC was drawn to analyze the prognostic value of serum HMGB1 and lncRNA H19,and the decision curve(DCA)was used to analyze the clinical benefits of serum HMGB1 and lncRNA H19 separately and jointly.Results The level of serum HMGB1 in death group was higher than that in survival group,and the level of lncRNA H19 was lower than that in survival group(t/P=5.212/<0.001,5.487/<0.001).Logistic regression analysis showed that the increase of serum HMGB1 was an independent risk factor for the prognosis of sepsis patients[OR(95%CI)=3.710(1.965-7.004)],and the increase of serum lncRNA H19 was an independent protective factor[OR(95%CI)=0.331(0.117-0.935)].The ROC curve results showed that the area under the curve(AUC)of serum HMGB1,lncRNA H19 and their combination in evaluating the prognosis of sepsis patients were 0.760,0.788 and 0.867,respectively.The combined prognostic value of the two was greater than the single prediction(Z/P=3.245/<0.001,2.641/0.008).The results of DCA curve showed that the net benefit rate of serum HMGB1 and lncRNA H19 combined evaluation model in evaluating the prognosis of sepsis patients was better than that of single detection within the threshold value of 0.23~0.73.Conclusion The increase of serum HMGB1 and the decrease of lncRNA H19 will increase the risk of death in sepsis patients at 28 d

关 键 词：脓毒症 高迁移率族蛋白B1 长链非编码RNA H19 预后 

分 类 号：R631.2[医药卫生—外科学]