血清OSM、Trx-1及HBP与脓毒症严重程度相关性及对临床转归的预测研究  

Correlation of serum OSM,Trx-1 and HBP with sepsis severity and prediction of clinical outcome

作　　者：周滟[1] 李晓茜[2] 汪思琴 ZHOU Yan;LI Xiao-qian;WANG Si-qin(Department of Critical Care Medicine,Leshan City Shizhong District People's Hospital,Leshan Sichuan 614000,China;Department of Critical Care Medicine,Leshan People's Hospital,Leshan Sichuan 614000,China)

机构地区：[1]乐山市市中区人民医院重症医学科,四川乐山614000 [2]乐山市人民医院重症医学科,四川乐山614000

出　　处：《临床和实验医学杂志》2024年第5期473-477,共5页Journal of Clinical and Experimental Medicine

基　　金：四川省专项科研课题项目(编号:JH22001)。

摘　　要：目的分析血清抑癌蛋白M(OSM)、硫氧还蛋白-1(Trx-1)及肝素结合蛋白(HBP)与脓毒症严重程度相关性及对临床转归的预测。方法回顾性选取2021年1月至2023年6月乐山市市中区人民医院收治的120例脓毒症患者作为研究对象,根据Sepsis-3.0脓毒症诊断标准,分为脓毒症组(n=82)和脓毒症休克组(n=38)。检测所有患者血清OSM、Trx-1及HBP水平,并进行急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ),比较2组患者及不同APACHEⅡ评分分层组间血清OSM、Trx-1及HBP水平,使用Spearman相关性分析对血清OSM、Trx-1及HBP水平与APACHEⅡ评分的相关性进行分析;根据患者的临床转归,将患者分为死亡组和存活组,比较两组血清OSM、Trx-1及HBP水平,使用受试者工作特征(ROC)曲线分析血清OSM、Trx-1及HBP对脓毒症临床转归的预测效能。结果脓毒症休克组血清OSM及HBP水平分别为(503.68±123.54)pg/mL、(145.53±36.71)ng/mL,均高于脓毒症组[(300.12±56.26)pg/mL、(45.21±10.29)ng/mL],Trx-1水平为(3.23±1.01)ng/mL,低于脓毒症组[(6.89±2.57)ng/mL],差异均有统计学意义(P<0.05)。随着脓毒症患者APACHEⅡ评分升高,血清OSM及HBP水平随之升高,Trx-1水平随之降低;血清OSM、Trx-1及HBP水平在APACHEⅡ评分各分层组间比较,差异均有统计学意义(P<0.05)。经Spearman相关性分析,脓毒症患者APACHEⅡ评分与血清OSM及HBP水平呈正相关(P<0.05),与Trx-1水平呈负相关(P<0.05)。死亡组患者血清OSM及HBP水平分别为(600.23±156.86)pg/mL、(168.42±52.31)ng/mL,均高于存活组[(180.16±28.79)pg/mL、(25.09±7.15)ng/mL],Trx-1水平为(1.89±0.52)ng/mL,低于存活组[(10.45±3.84)ng/mL],差异均有统计学意义(P<0.05)。经ROC曲线分析,血清OSM、Trx-1联合HBP预测脓毒症患者28 d死亡的曲线下面积为0.921,大于单项指标OSM的0.630、Trx-1的0.686和HBP的0.606(P<0.05)。结论血清OSM、Trx-1及HBP与脓毒症严重程度密切相关,三者联合可以提高对患者临床转归�Objective To analyze the correlation of serum tumor suppressor protein M(OSM),thioredoxin 1(Trx-1)and heparin-binding protein(HBP)with the severity of sepsis and the prediction of clinical outcome.Methods A total of 120 patients with Sepsis admitted to Leshan City Shizhong District People's Hospital from January 2021 to June 2023 were selected as the research objects.According to the diagnostic criteria of sepsis 3.0,they were divided into the sepsis group(n=82)and the septic shock group(n=38).Serum OSM,Trx-1 and HBP levels were detected in all patients,and acute physiology and chronic health status scoring systemⅡ(APACHEⅡ)were performed.Serum OSM,Trx-1 and HBP levels were compared between patients and groups with different APACHEⅡscores.The correlation between serum OSM,Trx-1 and HBP levels and APACHEⅡscore was analyzed by Spearman correlation.According to the clinical outcome,the patients were divided into death group and survival group.The serum OSM,Trx-1 and HBP levels of the two groups were compared,and the predictive efficacy of serum OSM,Trx-1 and HBP on the clinical outcome of sepsis was analyzed using receiver operating characteristic(ROC)curve.Results The levels of serum OSM and HBP in the septic shock group were(503.68±123.54)pg/mL,(145.53±36.71)ng/mL,respectively,which were higher than those in the sepsis group[(300.12±56.26)pg/mL,(45.21±10.29)ng/mL],and the level of Trx-1 was(3.23±1.01)ng/mL,which was lower than those in the sepsis group[(6.89±2.57)ng/mL],the differences were statistically significant(P<0.05).With the increase of APACHEⅡscore in sepsis patients,serum OSM and HBP levels increased,and Trx-1 levels decreased.There were statistically significant differences in serum OSM,Trx-1 and HBP levels among APACHEⅡscore groups(P<0.05).By Spearman correlation analysis,APACHEⅡscore was positively correlated with serum OSM and HBP levels(P<0.05),and negatively correlated with Trx-1 level(P<0.05).The serum OSM and HBP levels in the death group were(600.23±156.86)pg/mL and(168.42±5

关 键 词：硫氧还蛋白质类 急性生理学和长期健康评价 脓毒症 抑癌蛋白M 肝素结合蛋白 严重程度 临床转归 

分 类 号：R459.7[医药卫生—急诊医学]