外周血OLFM4、OLFM1 mRNA表达与脓毒症急性肺损伤病情严重程度及预后的关系  

Relationship between the expression of OLFM4 and OLFM1 mRNA in peripheral blood and the severity and prognosis of acute lung injury in sepsis

作　　者：刘斌[1] 徐丽丽[2] 王宁[1] 程志刚 刘冬[4] Liu Bin;Xu Lili;Wang Ning;Cheng Zhigang;Liu Dong(Department of Emergency,Tianjin Medical University Zhu Xianyi Memorial Hospital,Tianjin 300134,China;Department of General Medicine,the First Affiliated Hospital of Shihezi University,Shihezi 832000,China;Department of Laboratory Medicine,the First Affiliated Hospital of Shihezi University,Shihezi 832000,China;Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Shihezi University,Shihezi 832000,China)

机构地区：[1]天津医科大学朱宪彝纪念医院急诊科,天津300134 [2]石河子大学第一附属医院全科医学科,石河子832000 [3]石河子大学第一附属医院检验科,石河子832000 [4]石河子大学第一附属医院呼吸与危重症医学科,石河子832000

出　　处：《中国医师杂志》2024年第12期1846-1850,1856,共6页Journal of Chinese Physician

基　　金：石河子大学科研项目(ZZZC201715A)。

摘　　要：目的探究外周血嗅质蛋白(OLFM)4、OLFM1 mRNA表达与脓毒症急性肺损伤病情严重程度及预后的关系。方法选取2019年3月至2023年3月天津医科大学朱宪彝纪念医院和石河子大学第一附属医院收治的126例脓毒症急性肺损伤患者作为研究对象。采用实时荧光定量聚合酶链式反应法检测外周血OLFM4、OLFM1 mRNA表达。根据患者的病情严重程度分为低危组、中危组、高危组。根据治疗28 d预后分为生存组和死亡组。评价外周血OLFM4、OLFM1 mRNA表达与脓毒症急性肺损伤病情严重程度及预后的关系。结果126例脓毒症急性肺损伤患者,低危组26例、中危组56例、高危组44例。高危组外周血OLFM4、OLFM1 mRNA相对表达量均高于中危组、低危组,中危组外周血OLFM4、OLFM1 mRNA相对表达量高于低位组(均P<0.05)。外周血OLFM4、OLFM1 mRNA与病情严重程度呈正相关(r=0.671,P=0.001;r=0.594,P=0.001)。死亡组的序贯器官衰竭(SOFA)评分、急性生理学和慢性健康评估Ⅱ(APACHEⅡ)评分、乳酸、OLFM4 mRNA、OLFM1 mRNA均高于生存组(均P<0.05)。SOFA评分(OR=4.486,95%CI:2.097~9.598)、APACHEⅡ评分(OR=3.762,95%CI:1.758~8.049)、乳酸(OR=3.377,95%CI:1.578~7.225)、OLFM4 mRNA(OR=4.464,95%CI:2.086~9.550)、OLFM1 mRNA(OR=3.869,95%CI:1.808~8.278)是脓毒症急性肺损伤患者死亡的危险因素(均P<0.05)。外周血OLFM4、OLFM1 mRNA单一及联合预测脓毒症急性肺损伤患者死亡的灵敏度分别为0.726、0.685、0.806,特异度分别为0.683、0.729、0.729,曲线下面积分别为0.782、0.772、0.827。结论外周血OLFM4、OLFM1 mRNA表达与脓毒症急性肺损伤患者的病情进展有关,且在预后评价中表现出良好的预测效能。ObjectiveTo investigate the relationship between the expression of olfactomedin(OLFM)4 and OLFM1 mRNA in peripheral blood and the severity and prognosis of acute lung injury in sepsis.MethodsA total of 126 patients with acute lung injury from sepsis admitted to the Tianjin Medical University Zhu Xianyi Memorial Hospital and the First Affiliated Hospital of Shihezi University from March 2019 to March 2023 were selected as the study objects.The mRNA expression of OLFM4 and OLFM1 in peripheral blood was detected by real-time fluorescence quantitative polymerase chain reaction.According to the severity of the disease,the patients were divided into low-risk group,medium-risk group and high-risk group.According to the prognosis after 28 days of treatment,the patients were divided into survival group and death group.The relationship between the expression of OLFM4 and OLFM1 mRNA in peripheral blood and the severity and prognosis of acute lung injury in sepsis was evaluated.ResultsAmong 126 patients with acute lung injury due to sepsis,there were 26 cases in the low risk group,56 cases in the medium risk group and 44 cases in the high risk group.The relative expression levels of OLFM4 and OLFM1 mRNA in peripheral blood of the high-risk group were higher than those of the medium-risk group and the low-risk group,and the relative expression levels of OLFM4 and OLFM1 mRNA in peripheral blood of the medium-risk group were higher than those of the low-risk group(all P<0.05).OLFM4 and OLFM1 mRNA in peripheral blood were positively correlated with disease severity(r=0.671,P=0.001;r=0.594,P=0.001).The Sequential Organ Failure Assessment(SOFA)score,Acute physiology and Chronic Health AssessmentⅡ(APACHEⅡ)score,lactic acid,OLFM4 mRNA,OLFM1 mRNA in the death group were higher than those in the survival group(all P<0.05).SOFA score(OR=4.486,95%CI:2.097-9.598),APACHEⅡscore(OR=3.762,95%CI:1.758-8.049),lactic acid score(OR=3.377,95%CI:1.578-7.225),OLFM4 mRNA(OR=4.464,95%CI:2.086-9.550)and OLFM1 mRNA(OR=3.869,95%CI:1.808-8.278)were

关 键 词：脓毒症 急性肺损伤 嗅质蛋白1 嗅质蛋白4 

分 类 号：R459.7[医药卫生—急诊医学]