脓毒症并发ARDS患者血清Tim-3、Galectin-9表达及其与疾病转归的相关性  

Expression of serum Tim-3,Galectin-9 in patients with ARDS and its correlation with disease outcome

作　　者：周敏[1,2] 郭强 张伟 ZHOU Min;GUO Qiang;ZHANG Wei(Suzhou University School of Medicine,Suzhou 215301,China;Intensive Care Department of Hai'an People's Hospital,Hai'an 226600,China;Emergency Medicine Department of Suzhou University Affiliated Fourth Hospital(Suzhou Dushu Lake Hospital),Suzhou 215000,China)

机构地区：[1]苏州大学医学院,苏州215301 [2]海安市人民医院重症医学科,海安226600 [3]苏州大学附属第四医院(苏州市独墅湖医院)急诊医学科,苏州215000

出　　处：《国际免疫学杂志》2024年第5期496-502,共7页International Journal of Immunology

摘　　要：目的探讨脓毒症并发急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者血清T细胞免疫球蛋白黏蛋白分子3(T-cell immunoglobulin mucin molecule 3,Tim-3)、半乳糖凝集素9(galactose lectin 9,Galectin-9)表达及其与疾病转归的相关性。方法选取2021年12月至2023年11月海安市人民医院收治的103例脓毒症并发ARDS患者作为研究对象。根据氧合指数将103患者分为轻度组(31例),中度组(37例),重度组(35例)3个亚组。将患者血液标本外送检测机构检测血清Tim-3、Galectin-9水平。根据入院后28天内存活情况将103例患者分为生存组(54例)、死亡组(49例)。采用Spearman相关分析探讨血清Tim-3、Galectin-9与疾病转归的关系;采用受试者工作特性曲线评估评估价其值;采用多因素Logistic回归法分析相关影响因素。结果与轻度组相比,中度组、重度组脓毒症并发ARDS患者血清Tim-3、Galectin-9水平逐渐上升[ng/mL:(8.05±1.76)比(10.37±2.49)比(13.51±2.86);ng/L:(34.46±3.51)比(41.05±5.62)比(49.14±4.16),F值分别为7.06、7.55,P值均<0.05]。生存组患者血清Tim-3、Galectin-9水平低于死亡组[ng/mL:(9.36±2.07)比(13.79±1.95);ng/L:(37.24±4.02)比(51.36±6.43),t值分别为11.15、13.49,P值均<0.05]。脓毒症并发ARDS患者血清Tim-3、Galectin-9与疾病转归均呈正相关(r=0.607、0.549,P值均<0.001)。血清Tim-3、Galectin-9评估脓毒症并发ARDS患者疾病转归的曲线下面积[95%CI:0.762(0.701~0.813)、0.837(0.796~0.879)],两者联合预测的曲线下面积[95%CI:0.908(0.873~0.958)]。生存组入院24 h内急性生理与慢性健康评分(acute physiology and chronic health evaluation,APACHEⅡ)、入院24 h内序贯器官衰竭评分(sequential organ failure assessment,SOFA)、脓毒症休克比例、机械通气时间≥3 d比例低于死亡组(P<0.05)。多因素Logistic回归分析显示,APACHEⅡ≥15分(OR=2.349,95%CI:1.547~3.566)、SOFA≥12分(OR=2.140,95%CI:1.435~3.193)、Tim-3≥11.58 ng/mL(OR=2.67ObjectiveTo investigate the expression of serum T cell immunoglobulin mucin-3(Tim-3)and Galectin-9(Galectin-9)in patients with sepsis complicated with acute respiratory distress syndrome(ARDS)and their correlation with the disease outcome.MethodsA total of 103 cases with sepsis complicated with ARDS admitted to Hai'an People's Hospital from December 2021 to November 2023 were selected.According to the oxygenation index,103 cases were divided into 3 subgroups:mild group(31 cases),moderate group(37 cases)and severe group(35 cases).Blood samples were sent to testing institutions for detection of serum Tim-3 and Galectin-9 levels.According to the survival within 28 days after admission,103 cases were divided into survival group(54 cases)and death group(49 cases).Spearman correlation analysis was used to investigate the relationship between serum Tim-3,Galectin-9 and disease outcomes.Receiver operating characteristic curve was used to evaluate the evaluation value,and multivariate logistic regression was used to analyze the influencing factors.ResultsCompare with mild group,the aggravation of the disease,the serum levels of Tim-3 and Galectin-9 in cases with sepsis complicated with ARDS of moderate group and severe group increased gradually[ng/mL:(8.05±1.76)vs(10.37±2.49)vs(13.51±2.86);ng/L:(34.46±3.51)vs(41.05±5.62)vs(49.14±4.16),F values were 7.06、7.55,both P values<0.05].The levels of serum Tim-3 and Galectin-9 in survival group were lower than those in death group[ng/mL:(9.36±2.07)vs(13.79±1.95);ng/L:(37.24±4.02)vs(51.36±6.43),t values were 11.15、13.49,both P values<0.05].Serum Tim-3 and Galectin-9 were positively correlated with disease outcome in cases with sepsis complicated with ARDS(r=0.607,0.549,P<0.001).The AUC(95%CI)of serum Tim-3 and Galectin-9 for the outcome of ARDS cases with sepsis were 0.762(0.701~0.813)and 0.837(0.796~0.879).The combined forecast AUC(95%CI)was 0.908(0.873~0.958).APACHEⅡscore,SOFA score,proportion of septic shock and proportion of mechanical ventilation≥3 d in survi

关 键 词：脓毒症 呼吸窘迫综合征 T细胞免疫球蛋白黏蛋白分子3 半乳糖凝集素9 

分 类 号：R459.7[医药卫生—急诊医学]