脓毒症相关急性呼吸窘迫综合征患者血清SIRT1、ESM-1、FGF21表达水平与治疗结局的相关性分析  

Correlations of serum SIRT1,ESM-1 and FGF21 expression levels with therapeutic outcome in patients with sepsis-related acute respiratory distress syndrome

作　　者：王维 向泊羽 张千江 孙飞 WANG Wei;XIANG Boyu;ZHANG Qianjiang;SUN Fei(Department of Emergency,Guangyuan First People′s Hospital of Sichuan Province,Guangyuan,Sichuan,628000)

机构地区：[1]四川省广元市第一人民医院急诊科,四川广元628000

出　　处：《实用临床医药杂志》2025年第3期46-50,56,共6页Journal of Clinical Medicine in Practice

基　　金：2021年四川省医学(青年创新)科研课题(S211920)。

摘　　要：目的探讨脓毒症相关急性呼吸窘迫综合征(ARDS)患者血清沉默信息调节因子2相关酶1(SIRT1)、内皮细胞特异性分子-1(ESM-1)、成纤维细胞生长因子-21(FGF21)表达水平与治疗结局的相关性。方法选取140例脓毒症相关ARDS患者,根据治疗结局分为结局良好组96例与结局不良组44例。比较2组血清SIRT1、ESM-1、FGF21水平;分析血清SIRT1、ESM-1、FGF21与病情程度、治疗结局的相关性;评价血清SIRT1、ESM-1、FGF21对治疗结局的预测价值。结果结局不良组血清SIRT1水平低于结局良好组,ESM-1、FGF21水平高于结局良好组,差异有统计学意义(P<0.05);血清SIRT1水平在轻度患者、中度患者、重度患者中呈逐渐下降趋势,ESM-1、FGF21水平呈逐渐升高趋势,差异有统计学意义(P<0.05)。Spearman相关性分析显示,血清SIRT1与病情程度呈负相关(P<0.05),ESM-1、FGF21与病情程度呈正相关(P<0.05);偏相关性分析显示,血清SIRT1、ESM-1、FGF21与脓毒症相关ARDS患者治疗结局显著相关(P<0.05)。受试者工作特征(ROC)曲线显示,血清SIRT1、ESM-1、FGF21预测脓毒症相关ARDS患者治疗结局的曲线下面积(AUC)为0.742、0.838、0.796,敏感度为77.27%、77.27%、70.45%,特异度为64.58%、81.25%、87.50%;3项指标联合预测脓毒症相关ARDS患者治疗结局的AUC为0.939,敏感度为88.64%,特异度为83.33%,显著高于3项指标单独预测价值(P<005)。结论脓毒症相关ARDS患者血清SIRT1、ESM-1、FGF21水平与病情程度及治疗结局显著相关,具有独立预测治疗结局的能力,且联合预测价值更高。Objective To investigate the correlations of the expression levels of serum silencing information regulatory factor 2-related enzyme 1(SIRT1),endothelial cell-specific molecule-1(ESM-1),and fibroblast growth factor-21(FGF21)with therapeutic outcome in patients with sepsis-related acute respiratory distress syndrome(ARDS).Methods A total of 140 patients with sepsis-related ARDS were selected and divided into good outcome group(n=96)and poor outcome group(n=44)according to the therapeutic outcome.The levels of serum SIRT1,ESM-1 and FGF21 were compared between the two groups,and the correlations of serum SIRT1,ESM-1 and FGF21 with the severity of the disease and therapeutic outcome were analyzed.The predictive values of serum SIRT1,ESM-1 and FGF21 for therapeutic outcome were evaluated.Results The serum SIRT1 level in the poor outcome group was significantly lower,while the levels of ESM-1 and FGF21 were significantly higher than those in the good outcome group(P<0.05).The serum SIRT1 level showed a significant gradual downward trend in mild,moderate,and severe patients,while the ESM-1 and FGF21 levels showed a significant gradual upward trend in mild,moderate,and severe patients(P<0.05).Spearman correlation analysis showed that serum SIRT1 was significantly negatively correlated with disease severity,while ESM-1 and FGF21 were significantly positively correlated with disease severity(P<0.05).Partial correlation analysis showed that serum SIRT1,ESM-1 and FGF21 were significantly correlated with the therapeutic outcome of ARDS patients with sepsis(P<0.05).The receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)of serum SIRT1,ESM-1 and FGF21 for predicting the treatment outcome of sepsis-related ARDS patients was 0.742,0.838 and 0.796 respectively,with sensitivities of 77.27%,77.27%and 70.45%,and specificities of 64.58%,81.25%and 87.50%.The AUC of the combination of three indexes for predicting the therapeutic outcome of sepsis-related ARDS patients was 0.939,with a sensitivity of 88.6

关 键 词：脓毒症相关急性呼吸窘迫综合征 沉默信息调节因子2相关酶1 内皮细胞特异性分子-1 治疗结局 相关性 成纤维细胞生长因子-21 

分 类 号：R692[医药卫生—泌尿科学] R446.11[医药卫生—外科学] R319[医药卫生—临床医学]