血清抑瘤素M联合组蛋白H4在脓毒症诊断及预后评估中的意义  

Significance of serum oncostatin M combined with histone H4 in the diagnosis and prognostic evaluation of sepsis

作　　者：包志远 李从圣[1] 杨静[1] 胡承志[1] 丁斌 聂开政[1] 倪婳 BAO Zhiyuan;LI Congsheng;YANG Jing;HU Chengzhi;DING Bin;NIE Kaizheng;NI Hua(Emergency Department,The First People's Hospital of Hefei,Hefei,Anhui 230001,China)

机构地区：[1]合肥市第一人民医院急诊科,安徽合肥230001

出　　处：《安徽医药》2024年第5期949-952,共4页Anhui Medical and Pharmaceutical Journal

基　　金：安徽省医学会急诊分会临床研究项目(Ky2021008);合肥市卫健委应用医学重点项目(合卫科教(2019)172号)。

摘　　要：目的探讨血清抑瘤素M(OSM)联合组蛋白H4在脓毒症诊断及预后评估中的意义。方法选择2020年9月至2021年8月合肥市第一人民医院41例脓毒症病人为研究对象,使用酶联免疫吸附(ELISA)法测定脓毒症病人血清中抑瘤素M及组蛋白H4水平,选取年龄、性别相似的健康者40例为健康对照组;依据脓毒症病人28 d预后分为生存组和死亡组,使用统计学软件分析临床资料,比较两组血清抑瘤素M及组蛋白H4的差异。结果脓毒症组、脓毒性休克组病人血清OSM[55.49(41.96,63.09)ng/L、108.03(58.22,86.44)ng/L比40.85(27.92,51.26)ng/L]及H4[29.93(25.09,31.74)μg/L、34.81(28.03,36.16)μg/L比25.85(22.50,28.23)μg/L]水平均高于健康对照组(P<0.05)。与脓毒症组相比,脓毒性休克组中血清OSM及H4水平更高(P<0.05);ROC曲线分析,H4、OSM及二者联合对脓毒症的诊断的AUC为0.79、0.76、0.83,两者联合效能高于两者单独检测;与存活组相比,死亡组病人血清OSM[108.98(53.59,103.32)ng/L比52.01(42.26,62.05)ng/L]和H4[36.94(29.96,40.58)μg/L比27.45(25.37,28.59)μg/L]水平更高(P<0.05)。OSM、H4及联合分别绘制ROC曲线计算AUC分别为0.76(0.61.0.92)、0.82(0.69,0.95)和0.89(0.79,0.99)。结论抑瘤素M和组蛋白H4能用于对脓毒症早期诊断和预后评估,两者联合对脓毒症病人诊断效能及近期预后评估的能力有所提升。Objective To explore the significance of serum oncostatin M(OSM)combined with serum histone H4 in the diagnosis and prognostic evaluation of sepsis.Methods Forty-one patients with sepsis treated in The First People's Hospital of Hefei from Septem⁃ber 2020 to August 2021 were selected as the study subjects.The serum levels of OSM and histone H4 in sepsis patients were mea⁃sured by ELISA.Forty healthy people with corresponding age and sex were selected as the control group.The patients were assigned in⁃to survival group and death group according to the 28-day prognosis.The clinical data were analyzed with statistical software,and the differences in OSM and histone H4 were compared between the two groups.Results The levels of serum OSM[55.49(41.96,63.09)ng/L,108.03(58.22,86.44)ng/L vs.40.85(27.92,51.26)ng/L]and H4[29.93(25.09,31.74)μg/L,34.81(28.03,36.16)μg/L vs.25.85(22.50,28.23)μg/L]in sepsis group and septic shock group were higher than those in control group(P<0.05).Compared with sepsis group,the levels of serum OSM and H4 in septic shock group were higher(P<0.05);ROC curve analysis results showed that the AUCs of H4,OSM and their combination in the diagnosis of sepsis were 0.79,0.76,and 0.83,respectively,and their combined efficacy was higher than that of both alone.Compared with the survival group,the patients in the death group had higher serum OSM[108.98(53.59,103.32)ng/L vs.52.01(42.26,62.05)ng/L]and H4 levels[36.94(29.96,40.58)μg/L vs.27.45(25.37,28.59)μg/L](P<0.05).The AUC values of OSM,H4 and the combination respectively were 0.76(0.61,0.92),0.82(0.69,0.95)and 0.89(0.79,0.99).Conclusion On⁃costatin M and histone H4 can be used for the early diagnosis and prognostic evaluation of sepsis,and the combination of them can im⁃prove the diagnostic efficacy and short-term prognostic evaluation of sepsis patients.

关 键 词：脓毒症 抑瘤素M 组蛋白H4 预后 

分 类 号：R459.7[医药卫生—急诊医学]