硫氧还蛋白-1与脓毒症心肌病短期不良心血管事件发生的关系  

The relationship between thioredoxin 1 and short-term adverse cardiac events in septic cardiomyopathy

作　　者：路敦琳 徐珊珊[1] 刘勇 LU Dunlin;XU Shanshan;LIU Yong(Department of Emergency,Affiliated Hospital of Weifang Medical University,Weifang,261000,China)

机构地区：[1]潍坊医学院附属医院急诊科,山东潍坊261000

出　　处：《临床血液学杂志》2024年第4期252-256,262,共6页Journal of Clinical Hematology

摘　　要：目的:分析硫氧还蛋白(Trx)-1与脓毒症心肌病短期主要不良心血管事件(MACE)发生的关系。方法:纳入并分析2020年3月—2023年2月在医院急诊重症监护病房(EICU)内接受诊治的135例脓毒症心肌病患者,入院常规行血液检查及资料评估,以入院28 d的内发生MACE为研究终点,将患者分为MACE组和非MACE(N-MACE)组。采用logistic回归和限制性立方样条法,分析血清Trx-1与脓毒症心肌病短期内发生MACE的关系。结果:本研究中135例脓毒症心肌病患者,入院28 d内发生MACE共52例,发生时间为4~25 d,平均(13.83±5.52)d,发生率为38.52%。MACE组患者体温>38.3℃、慢性肾脏疾病(CKD)比例、急性生理与慢性健康评分(APACHEⅡ)、N末端前体脑利钠肽(NT-proBNP)、白细胞介素(IL)-6及Trx-1水平均高于N-MACE组,24 h乳酸清除率、左心室射血分数(LVEF)低于N-MACE组,差异有统计学意义(P<0.05)。采用logistic回归分析,体温>38.3℃,APACHEⅡ评分升高,乳酸清除不足,LVEF减低,血清Trx-1、IL-6水平异常升高与脓毒症心肌病患者入院28 d内MACE风险增加有关(P<0.05)。采用限制性立方样条法分析,血清Trx-1与脓毒症心肌病患者入院28 d内MACE发生风险呈正向线性关系(P<0.05)。结论:脓毒症心肌病患者血清Trx-1水平异常升高与入院28 d内发生MACE有关,MACE风险随着血清Trx-1水平升高而增加。Objective To analyze the relationship between thioredoxin(Trx)-1 and the occurrence of short-term major adverse cardiac events(MACE)in septic cardiomyopathy.Methods A total of 135 patients with septic cardiomyopathy who received treatment in emergency intensive care unit(EICU)of hospital from March 2020 to February 2023 were included and analyzed.135 patients underwent routine blood tests and data evaluation upon admission,with MACE occurring within 28 days of admission as the study endpoint.The patients were divided into the MACE group and the non MACE(N-MACE)group.logistic regression and restricted cubic spline method were used to analyze the relationship between serum Trx-1 and short-term MACE in septic cardiomyopathy.Results Among the 135 patients with septic cardiomyopathy in this study,a total of 52 cases of MACE occurred within 28 days of admission,with an average occurrence time of(13.83±5.52)days and an incidence rate of 38.52%,ranging from 4 to 25 days.The MACE group had higher body temperature>38.3℃,a higher proportion of chronic kidney disease(CKD),higher acute physiological and chronic health scores(APACHEⅡ),and higher levels of N-terminal precursor brain natriuretic peptide(NT-proBNP),interleukin-6(IL-6)and Trx-1 levels compared to the N-MACE group.The 24-hour lactate clearance rate and left ventricular ejection fraction(LVEF)were lower than those of N-MACE group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that body temperature higher than>38.3℃,APACHEⅡscore increased,insufficient lactate clearance,LVEF decreased,abnormal increase of serum Trx-1 and IL-6 levels were related to the increased risk of MACE in patients with septic cardiomyopathy within 28 days of admission(P<0.05).The restricted cubic spline method showed that there was the positive linear relationship between serum Trx-1 and the risk of MACE within 28 days of admission in patients with septic cardiomyopathy(P<0.05).Conclusion The abnormal increased in serum Trx-1 levels in pat

关 键 词：脓毒症心肌病 不良心血管事件 硫氧还蛋白-1 

分 类 号：R446.11[医药卫生—诊断学]