不同疾病活动程度溃疡性结肠炎患者血清SGK1、XBP1水平变化及与预后的相关性  

A study on the changes in serum SGK1 and XBP1 levels and their correlation with prognosis in ulcerative colitis patients with different disease activity levels

作　　者：张熙 薛麟 罗长琴[1] 孙佳森 王桢哲 Zhang Xi;Xue Lin;Luo Changqin;Sun Jiasen;Wang Zhenzhe(Department of Gastroenterology,Ankang Central Hospital,Shaanxi,Ankang 725000,China)

机构地区：[1]陕西省安康市中心医院消化内科,725000

出　　处：《疑难病杂志》2025年第2期175-180,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：陕西省科技计划项目(2021SF-106)。

摘　　要：目的探讨不同疾病活动程度溃疡性结肠炎(UC)患者血清/糖皮质激素调节激酶1(SGK1)、X盒结合蛋白1(XBP1)水平变化及其与预后的相关性。方法选取2021年1月—2024年1月安康市中心医院消化内科收治的活动期UC患者92例为活动期组和缓解期UC患者92例为缓解期组,活动期组UC患者根据疾病活动程度分为轻度活动期亚组24例、中度活动期亚组29例、重度活动期亚组39例,根据6个月预后情况分为不良预后亚组34例和良好预后亚组58例。采用酶联免疫吸附法检测血清SGK1、XBP1水平;多因素Logistic回归分析活动期UC患者预后不良的影响因素;受试者工作特征(ROC)曲线评价血清SGK1、XBP1水平对活动期UC患者预后不良的预测效能。结果活动期组血清SGK1水平高于缓解期组,血清XBP1水平低于缓解期组(t/P=11.051/<0.001,14.639/<0.001);伴随疾病活动程度加重,活动期UC患者血清SGK1水平逐渐升高,血清XBP1水平逐渐降低(F/P=215.932/<0.001,269.335/<0.001);92例活动期UC患者预后不良率为36.96%(34/92),不良预后亚组疾病活动重度比例、血清SGK1水平高于良好预后亚组,血清XBP1水平低于良好预后亚组(χ^(2)/t/P=4.852/<0.001,5.689/<0.001,5.077/<0.001);多因素Logistic回归分析显示,疾病活动重度、血清SGK1水平高为活动期UC患者不良预后的独立危险因素[OR(95%CI)=4.929(1.756~13.833),1.147(1.053~1.250)],血清XBP1高为独立保护因素[OR(95%CI)=0.783(0.677~0.905)];血清SGK1、XBP1水平及二者联合预测活动期UC患者不良预后的曲线下面积(AUC)为0.795、0.792、0.881,二者联合预测活动期UC患者不良预后的AUC大于血清SGK1、XBP1水平单独预测(Z/P=2.122/0.034,2.382/0.017)。结论UC患者血清SGK1水平升高、XBP1水平降低,其与疾病活动程度加重和预后不良相关,二者联合预测活动期UC患者预后的效能较高。Objective To investigate the changes in serum levels of serum/glucocorticoid-regulated kinase 1(SGK1)and X-box binding protein 1(XBP1)in ulcerative colitis(UC)patients with varying degrees of disease activity,and to explore their correlation with prognosis.Methods A total of 92 active-phase UC patients and 92 remission-phase UC patients were selected from the Department of Gastroenterology,Ankang Central Hospital,from January 2021 to January 2024.The active-phase UC patients were further divided into mild,moderate,and severe subgroups based on disease activity(24,29,and 39 patients,respectively).According to the 6-month prognosis,patients were categorized into poor prognosis(34 patients)and good prognosis(58 patients)subgroups.Serum SGK1 and XBP1 levels were measured by enzyme-linked immunosorbent assay.The correlation between serum SGK1 and XBP1 levels and prognosis in active-phase UC patients was analyzed using multivariate unconditional logistic regression and ROC curve analysis.Results The serum SGK1 level in the active-phase group was higher than that in the remission-phase group,while the serum XBP1 level was lower in the active-phase group(t/P=11.051/<0.001,14.639/<0.001).Among active phase subgroups,SGK1 levels were highest in the severe activity subgroup,followed by the moderate and mild activity subgroups,while XBP1 levels were lowest in the severe activity subgroup,followed by the moderate and mild activity subgroups(F/P=215.932/<0.001,269.335/<0.001).The unfavorable prognosis rate among active phase UC patients was 36.96%(34/92).Compared with the favorable prognosis subgroup,the unfavorable prognosis subgroup exhibited higher disease severity and SGK1 levels,and lower XBP1 levels(χ^(2)/t/P=4.852/<0.001,5.689/<0.001,5.077/<0.001).Severe disease activity and elevated SGK1 were independent risk factors for unfavorable prognosis in active phase UC,while elevated XBP1 was an independent protective factor[OR(95%CI)=4.929(1.756 to 13.833),1.147(1.053 to 1.250),0.783(0.677 to 0.905)].The area under the curve

关 键 词：溃疡性结肠炎 血清/糖皮质激素调节激酶1 X盒结合蛋白1 疾病活动程度 预后 

分 类 号：R574.62[医药卫生—消化系统]