血清MCP-1和MIP-1β水平与老年脓毒症患者心肌损伤的相关性  

Correlation between serum MCP-1,MIP-1βlevels and myocardial injury in elderly patients with sepsis

作　　者：万林 樊媛[2] 张瑞[2] WAN Lin;FAN Yuan;ZHANG Rui(Department of Emergency,Northwestern Polytechnical University Hospital,Xi’an 710068,Shaanxi,China;Department of Emergency,The Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,Shaanxi,China)

机构地区：[1]西北工业大学医院急诊科,陕西西安710068 [2]西安交通大学第二附属医院急诊科,陕西西安710004

出　　处：《心脏杂志》2024年第4期412-416,共5页Chinese Heart Journal

摘　　要：目的探讨血清单核细胞趋化因子蛋白1(MCP-1)和巨噬细胞炎性蛋白-1β(MIP-1β)水平与老年脓毒症患者心肌损伤的相关性。方法前瞻纳入2021年3月~2022年3月医院50例出现心肌损伤的老年脓毒症患者,纳入心肌损伤组,同期50例未出现心肌损伤的老年脓毒症患者,纳入非心肌损伤组,测定并比较两组入院时血清MCP-1和MIP-1β水平,分析血清MCP-1和MIP-1β水平与老年脓毒症患者心肌损伤的关系。结果心肌损伤组血清心肌肌钙蛋白T(cTnT)、B型钠尿肽前体(Pro-BNP)、肌酸激酶同工酶(CK-MB)、MCP-1和MIP-1β表达水平高于非心肌损伤组,差异有统计学意义(均P<0.01);经单项Logistic回归分析后建立多元回归模型行多因素分析,结果显示,血清c TnT、Pro-BNP、CK-MB、MCP-1、MIP-1β表达与老年脓毒症患者心肌损伤有关,可能是老年脓毒症患者心肌损伤的预测因素(OR>1,P<0.05);绘制ROC曲线发现,血清MCP-1、MIP-1β表达单独及联合预测老年脓毒症患者心肌损伤的AUC均>0.850,均有一定预测价值。结论血清MCP-1、MIP-1β过表达可能与老年脓毒症患者心肌损伤有关,增加心肌损伤,联合检测老年脓毒症早期血清MCP-1和MIP-1β水平可预测心肌损伤风险。AIM to myocardial injury refers to the myocardial cell damage or necrosis caused by various causes,accompanied by the release of various enzymes into the peripheral blood,leading to cardiac dysfunction.Objective To investigate the correlation between serum levels of monocyte chemokine protein-1(MCP-1)and macrophage inflammatory protein-1β(MIP-1β)and myocardial injury in elderly patients with sepsis.METHODS 50 elderly sepsis patients with myocardial injury in the hospital from March 2021 to March 2022 were included in the myocardial injury group,and 50 elderly sepsis patients without myocardial injury were included in the non-myocardial injury group during the same period.Serum MCP-1 and MIP-1βlevels were measured and compared between the two groups at admission.To analyze the relationship between serum MCP-1,MIP-1βlevels and myocardial injury in elderly patients with sepsis.RESULTS The expression levels of serum cardiac troponin T(cTnT),B-type natriuretic peptide precursor(Pro-BNP),creatine kinase isoenzyme(CK-MB),MCP-1 and MIP-1βin myocardial injury group were higher than those in non-myocardial injury group,and the differences were statistically significant(P<0.01).Multivariate regression model was established after single Logistic regression analysis for multivariate analysis.The results showed that the expression of serum cTnT,Pro-BNP,CK-MB,MCP-1,MIP-1βwas associated with myocardial injury in elderly sepsis patients,and may be a predictor of myocardial injury in elderly sepsis patients(OR>1,P<0.05).The ROC curve showed that the AUC of serum MCP-1 and MIP-1βexpression alone and in combination were more than 0.850 in predicting myocardial injury in elderly patients with sepsis,which had certain predictive value.CONCLUSION The overexpression of serum MCP-1 and MIP-1βmay be related to myocardial injury in elderly patients with sepsis,and increase myocardial injury.Combined detection of serum MCP-1 and MIP-1βlevels in early stage of elderly sepsis can predict the risk of myocardial injury.

关 键 词：脓毒症 老年 心肌损伤 单核细胞趋化因子蛋白1 巨噬细胞炎性蛋白-1β 相关性 

分 类 号：R542.2[医药卫生—心血管疾病]