血清SIRT3、SIRT6与脓毒症并发急性呼吸窘迫综合征及预后的关系研究  

Relationship between serum SIRT3,SIRT6 and sepsis complicated with acute respiratory distress syndrome and prognosis

作　　者：尚红亮 李鹏[2] 吕艳超[1] SHANG Hongliang;LI Peng;LYU Yanchao(Third Department of Critical Care Medicine,Baoding First Central Hospital,Baoding,Hebei 071000,China;Third Department of Clinical Laboratory,Baoding First Central Hospital,Baoding,Hebei 071000,China)

机构地区：[1]保定市第一中心医院重症医学三科,河北保定071000 [2]保定市第一中心医院检验三科,河北保定071000

出　　处：《国际检验医学杂志》2024年第4期385-391,共7页International Journal of Laboratory Medicine

基　　金：国家重点研发计划项目(2017YFC0907623)。

摘　　要：目的探讨血清沉默信息调节因子2相关酶(SIRT)3、SIRT6与脓毒症并发急性呼吸窘迫综合征(ARDS)及预后的关系。方法选取2020年3月至2022年2月保定市第一中心医院收治的68例脓毒症并发ARDS患者为研究对象,根据轻度、中度和重度ARDS标准将其分为轻度组、中度组、重度组;根据28 d内预后情况将患者分为生存组和死亡组。采用酶联免疫吸附试验检测血清SIRT3、SIRT6水平。比较各组序贯器官功能衰竭评估(SOFA)评分、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、血清SIRT3、SIRT6水平。收集患者的临床资料,采用单因素及多因素Logistic回归分析脓毒症并发ARDS患者死亡的影响因素;采用受试者工作特征(ROC)曲线分析血清SIRT3、SIRT6对脓毒症并发ARDS患者死亡的预测价值。结果中度组、重度组血清SIRT3、SIRT6水平低于轻度组,SOFA评分和APACHEⅡ评分高于轻度组,重度组血清SIRT3、SIRT6水平低于中度组,SOFA评分和APACHEⅡ评分高于中度组,差异有统计学意义(P<0.05)。两组年龄、机械通气时间、乳酸、动脉氧合指数[动脉血氧分压(PaO2)/吸入氧浓度(FiO2)]、C反应蛋白(CRP)、白细胞介素(IL)-6、SIRT3、SIRT6、SOFA评分、APACHEⅡ评分比较,差异有统计学意义(P<0.05)。机械通气时间较长、乳酸较高、CRP较高、IL-6较高、SOFA评分较高和APACHEⅡ评分较高均为脓毒症并发ARDS患者28 d内死亡的危险因素,PaO2/FiO2较大、SIRT3较高、SIRT6较高则为保护因素(P<0.05)。ROC曲线结果显示,血清SIRT3、SIRT6水平、SOFA评分、APACHEⅡ评分单独及联合应用时曲线下面积及95%CI分别为0.706(0.493~0.922)、0.722(0.497~0.954)、0.753(0.570~0.922)、0.710(0.442~0.952)、0.872(0.761~0.976)。结论脓毒症并发ARDS患者血清SIRT3、SIRT6水平降低,且随着病情加重,血清SIRT3、SIRT6水平越低,两者可辅助预测脓毒症并发ARDS患者的预后。Objective To explore the relationship between serum silent information regulator 2 related enzyme(SIRT)3,SIRT6,and sepsis complicated with acute respiratory distress syndrome(ARDS)and prognosis.Methods Sixty-eight patients with sepsis complicated with ARDS admitted to the Baoding First Central Hospital from March 2020 to February 2022 were selected as the study objects,and were divided into mild group,moderate group and severe group according to the criteria of mild,moderate and severe ARDS.According to the prognosis within 28 days,the patients were divided into survival group and death group.The levels of serum SIRT3 and SIRT6 were detected by enzyme-linked immunosorbent assay.The sequential organ failure assessment(SOFA)scores,acute physiology and chronic health evaluationⅡ(APACHEⅡ)scores,the levels of serum SIRT3 and SIRT6 in each group were compared.The clinical data of patients were collected,the influencing factors of mortality in patients with sepsis complicated with ARDS was analyzed by univariate and multivariate Logistic regression.The predictive value of serum SIRT3 and SIRT6 of mortality in patients with sepsis complicated with ARDS was analyzed by receiver operating characteristic(ROC)curve.Results The levels of serum SIRT3 and SIRT6 in moderate group and severe group were lower than those in mild group,the scores of SOFA and APACHEⅡwere higher than those in mild group,the levels of serum SIRT3 and SIRT6 in severe group were lower than those in moderate group,and the scores of SOFA and APACHEⅡwere higher than those in moderate group,with statistical significance(P<0.05).There were statistically significant differences in age,mechanical ventilation time,lactate,arterial oxygenation index[arterial partial pressure of oxygen(PaO 2)/inhaled oxygen concentration(FiO 2)],C reactive protein(CRP),interleukin(IL)-6,SIRT3,SIRT6,SOFA score and APACHEⅡscore between the two groups(P<0.05).Longer mechanical ventilation time,higher lactic acid,higher CRP,higher IL-6,higher SOFA score and higher APACHEⅡs

关 键 词：脓毒症 急性呼吸窘迫综合征 沉默信息调节因子2相关酶3 沉默信息调节因子2相关酶6 预后 

分 类 号：R459.7[医药卫生—急诊医学] R563.8[医药卫生—治疗学]