脓毒症患者血清SERPING1、SERPINE1水平变化及预后意义  

Changes and clinical significance of serum SERPING1 and SERPINE1 levels in patients with sepsis

作　　者：汪矛斐 池丹丹 姜立国 俞淙轶 龙贻文[1] 周文君 WANG Maofei;CHI Dandan;JIANG Liguo;YU Congyi;LONG Yiwen;ZHOU Wenjun(Department of Intensive Care Medicine,Luwan Branch of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,200020,China)

机构地区：[1]上海交通大学医学院附属瑞金医院卢湾分院重症医学科,上海200020

出　　处：《国际检验医学杂志》2024年第21期2615-2619,共5页International Journal of Laboratory Medicine

基　　金：上海市科学技术委员会科研计划项目(20441901000)。

摘　　要：目的研究脓毒症患者血清蛋白酶C1抑制剂(SERPING1)、纤溶酶原激活物抑制剂1型(SERPINE1)的表达及预后意义。方法选取2018年3月至2020年3月在该院诊治的132例脓毒症患者为脓毒症组,根据入院28 d内是否死亡,分为死亡组(34例)和生存组(98例)。采用酶联免疫吸附试验检测血清SERPING1、SERPINE1水平。采用多因素Logistic回归模型和受试者工作特征曲线研究血清SERPING1,SERPINE1评估患者死亡的预测价值。结果[相比于对照组,脓毒症组患者血清SERPING1(331.12±51.80 ng/L vs.639.04±91.12 ng/L)水平较低,血清SERPINE1(412.67±64.84 ng/L vs.42.33±10.32 ng/L)水平较高,差异有统计学意义(均P<0.05)]。相比于生存组,死亡组患者血清SERPINE1、降钙素原、C反应蛋白、急性生理与慢性健康评分(APACHEⅡ)评分和序贯器官衰竭评估(SOFA)评分较高,血清SERPING1水平较低,差异有统计学意义(均P<0.05)。血清SERPING1水平与APACHEⅡ评分、SOFA评分呈负相关(r=-0.779、-0.653,均P<0.05),血清SERPINE1水平与APACHEⅡ评分、SOFA评分呈正相关(r=0.740、0.685,均P<0.05)。血清SERPINE1水平、APACHEⅡ评分和SOFA评分是患者死亡的危险因素,血清SERPING1是保护因素。血清SERPING1、SERPINE1联合检测对脓毒症患者死亡预后评估的曲线下面积为0.938(95%CI:0.893~0.968),高于单项指标检测0.860(95%CI:0.812~0.899)、0.838(95%CI:0.781~0.868),差异有统计学意义(Z=3.861、4.015,均P<0.001)。结论脓毒症患者血清SERPING1、SERPINE1水平升高,与患者病情程度有关,两者联合对脓毒症患者预后具有较高的评估价值。Objective To investigate the expression and prognostic significance of serum protease C1 inhibitor(SERPING1)and plasminogen activator inhibitor type 1(SERPINE1)in patients with sepsis.Methods A total of 132 patients with sepsis treated in the hospital from March 2018 to March 2020 were selected as the sepsis group.According to whether they died within 28 days of admission,they were divided into a death group(n=34)and a survival group(n=98).Enzyme linked immunosorbent assay was used to detect the expression of serum SERPING1 and SERPINE1.Multivariate Logistic regression model and receiver operating characteristic curve were used to study the value of serum SERPING1 and serpine1 in evaluating the prognosis of patients'death.Results[Compared with the control group,serum SERPING1(331.12±51.80 ng/L vs.639.04±91.12 ng/L)was lower and serum serpine1(412.67±64.84 ng/L vs.42.33±10.32 ng/L)was higher in the sepsis group,and the differences were statistically significant(P<0.05).]Compared to the survival group,the levels of serum SERPINE1,procalcitonin,C-reactive protein,Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score and Sequential Organ Failure Assessment(SOFA)score in the death group were higher,while serum SERPING1 was lower,and the differences were statistically significant(all P<0.05).Serum SERPING1 showed negative correlation with APACHEⅡand SOFA scores(r=-0.779,-0.653,P<0.05),while serum SERPINE1 showed positive correlation with APACHEⅡand SO-FA scores(r=0.740,0.685,P<0.05).APACHEⅡscore,SOFA score,and serum SERPINE1 were risk fac-tors affecting the prognosis of sepsis patients,while serum SERPING1 was a protective factor.The area under the curve of serum SERPING1 and SERPINE1 combined for the evaluation of the death in sepsis patients was 0.938(95%CI:0.893-0.968),which was significantly higher than 0.860(95%CI:0.812-0.899)and 0.838(95%CI:0.781-0.868)of the single detection,and the differences were statistically significant(Z=3.861,4.015,P<0.001).Conclusion The elevated levels of serum SER

关 键 词：脓毒症 蛋白酶C1抑制剂 纤溶酶原激活物抑制剂1型 预后 

分 类 号：R459.7[医药卫生—急诊医学]