血清FGF9、Sestrin2及HBDH与脓毒症严重程度的相关性及对临床转归的预测研究  

Correlation of serum FGF9, Sestrin2 and HBDH with sepsis severity and prediction of clinical outcome

作　　者：谭文涛 李卫东[1] 张美琪 沈玄洋 TAN Wen-tao;LI Wei-dong;ZHANG Mei-qi(Department of Emergency,Affiliated Hospital of North Sichuan Medical College,Nanchong Sichuan 637000,China)

机构地区：[1]川北医学院附属医院急诊科,四川南充637000

出　　处：《临床和实验医学杂志》2025年第1期21-25,共5页Journal of Clinical and Experimental Medicine

基　　金：四川省医学会课题研究项目(编号:S22101)。

摘　　要：目的 探讨血清成纤维细胞生长因子9(FGF9)、Sestrin2及羟基丁酸脱氢酶(HBDH)与脓毒症严重程度的相关性,并分析FGF9、Sestrin2、HBDH对临床转归的预测价值。方法 回顾性选取2022年5月至2024年5月川北医学院附属医院收治的125例脓毒症患者进行研究。根据病情严重程度分为脓毒症组75例,脓毒性休克组50例;并根据患者的临床转归,将患者分为死亡组103例,存活组22例。观察各组血清FGF9、Sestrin2、HBDH水平;采用Spearman相关系数模型分析FGF9、Sestrin2、HBDH与脓毒症严重程度的相关性;采用多因素Logistics回归分析对影响脓毒症患者预后的因素进行分析;采用受试者操作特征(ROC)曲线分析FGF9、Sestrin2、HBDH对脓毒症患者预后的预测价值。结果 与脓毒症组相比,脓毒性休克组FGF9水平较低[(122.41±21.45)pg/mL vs.(145.36±23.68)pg/mL],Sestrin2、HBDH水平均较高[(15.75±2.34)ng/mL vs.(8.36±0.93)ng/mL、(232.14±34.77)U/L vs.(166.25±24.85)U/L],差异均有统计学意义(P<0.05)。与存活组相比,死亡组患者FGF9水平较低[(112.05±20.61)pg/mL vs.(133.25±22.14)pg/mL],Sestrin2、HBDH水平均较高[(19.25±2.85)ng/mL vs.(12.42±2.33)ng/mL、(261.25±37.25)U/L vs.(204.25±32.18)U/L],差异均有统计学意义(P<0.05)。Spearman相关系数分析结果显示,FGF9与脓毒症严重程度呈负相关(P<0.05),Sestrin2、HBDH与脓毒症严重程度呈正相关(P<0.05)。多因素Logistics回归分析结果显示,序贯器官衰竭评估(SOFA)评分、急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分、降钙素原、白细胞计数、中性粒细胞计数、血小板计数、血肌酐、FGF9、Sestrin2、HBDH均为影响脓毒症患者预后的危险因素(P<0.05)。ROC曲线分析结果显示,FGF9、Sestrin2、HBDH联合检测对脓毒症患者预后的预测效果较好(P<0.05)。结论 在脓毒症休克患者体内,FGF9水平较低,Sestrin2、HBDH水平较高;随着疾病严重程度加重,FGF9水平逐渐降低,Sestrin2�Objective To investigate the correlation between serum fibroblast growth factor-9(FGF9),Sestrin2 and hydroxybutyrate dehydrogenase(HBDH)and the severity of sepsis,and to analyze the prediction of FGF9,Sestrin2 and HBDH on clinical outcome.Methods A retrospective study was conducted on 125 patients with sepsis admitted to the Affiliated Hospital of North Sichuan Medical College from May 2022 to May 2024.According to the severity of the disease,the patients were divided into a sepsis group(75 cases)and a septic shock group(50 cases).According to the clinical outcome,the patients were divided into the death group(103 cases)and the survival group(22 cases).The levels of serum FGF9,Sestrin2 and HBDH in each group were observed.The correlation between FGF9,Sestrin2,HBDH and the severity of sepsis were analyzed using Spearman correlation coefficient model.the factors affecting the prognosis of patients with sepsis were analyzed using multivariate Logistics regression analysis.The predictive value of FGF9,Sestrin2 and HBDH on the prognosis of patients with sepsis were analyzed by receiver operating characteristic(ROC)curve.Results Compared with the sepsis group,the FGF9 level in septic shock group was lower[(122.41±21.45)pg/mL vs.(145.36±23.68)pg/mL],Sestrin2 and HBDH levels were higher[(15.75±2.34)ng/mL vs.(8.36±0.93)ng/mL,(232.14±34.77)U/L vs.(166.25±24.85)U/L],the differences were statistically significant(P<0.05).Compared with the survival group,the FGF9 level in the death group was lower[(112.05±20.61)pg/mL vs.(133.25±22.14)pg/mL],and the levels of Sestrin2 and HBDH were higher[(19.25±2.85)ng/mL vs.(12.42±2.33)ng/mL,(261.25±37.25)U/L vs.(204.25±32.18)U/L],the differences were statistically significant(P<0.05).Spearman correlation coefficient results showed that the FGF9 was negatively correlated with the severity of sepsis,while Sestrin2 and HBDH were positively correlated with the severity of sepsis(P<0.05).Multifactor Logistics regression analysis results showed that sequential organ failure assessment

关 键 词：脓毒症 成纤维细胞生长因子9 Sestrin2 羟丁酸脱氢酶 临床转归 

分 类 号：R72[医药卫生—儿科]