脓毒症心肌损伤患者血清SGK1和HE4联合检测在病情诊断与预后预测中的价值  

Values of Combined Detection of Serum SGK1 and HE4 in Diagnosis and Prognosis Prediction in Patients with Sepsis Myocardial Injury

作　　者：江峰 陈鹏 肖晓 夏艳霞 杨洋 Jiang Feng;Chen Peng;Xiao Xiao(Intensive Care Unit,Wuhan Seventh Hospital,Wuhan,Hubei 430071,China)

机构地区：[1]武汉市第七医院重症医学科,湖北武汉430071

出　　处：《四川医学》2025年第2期167-171,共5页Sichuan Medical Journal

摘　　要：目的 探讨血清糖皮质激素诱导激酶1(SGK1)和人附睾蛋白4(HE4)水平联合检测在脓毒症心肌损伤患者病情诊断和预后预测中的应用价值。方法 选取2019年9月至2022年9月在我院就诊的152例脓毒症患者作为研究对象。根据患者心肌肌钙蛋白T(cTnT)水平分为心肌损伤组(66例)和非心肌损伤组(86例),并根据心肌损伤患者治疗28 d后的预后情况将其分为预后良好组(43例)和预后不良组(23例)。采用酶联免疫吸附法(ELISA)对各组血清SGK1,HE4水平进行检测,并对心肌损伤组和非心肌损伤组的一般资料进行比较;采用Pearson法对脓毒症患者血清SGK1和HE4水平相关性进行分析;采用Logistic回归分析影响脓毒症患者发生心肌损伤的相关因素;进一步通过受试者工作特征(ROC)曲线评估血清SGK1、HE4水平以及二者联合对脓毒症心肌损伤患者预后情况的预测价值分析。结果 心肌损伤组较非心肌损伤组血清SGK1、HE4水平均升高,差异有统计学意义(P<0.05);脓毒症患者心肌损伤组、非心肌损伤组性别构成、年龄、体质指数、是否存在冠心病、收缩压、心率、呼吸及血清乳酸水平比较,差异均无统计学意义(P>0.05),两组患者血清清蛋白、尿素氮、左心室射血分数、cTnT比较,差异均有统计学意义(P<0.05);Pearson法分析结果显示,脓毒症患者血清SGK1与HE4水平呈正相关(P<0.05);Logistic回归分析显示,尿素氮、cTnT、血清SGK1水平、血清HE4水平是脓毒症患者发生心肌损伤的危险因素,血清清蛋白、左心室射血分数是脓毒症患者发生心肌损伤的保护因素(P<0.05);预后不良组血清SGK1、HE4水平均高于预后良好组,差异均有统计学意义(P<0.05);血清SGK1、HE4二者联合检测脓毒症心肌损伤患者预后情况预测价值分析的AUC为0.885,敏感度和特异度分别为78.26%和86.05%,优于SGK1和HE4单独预测(Z二者联合-SGK1=2.816,P=0.005、Z二者联合-HE4=2.551,P=0.011)。结Objective To explore application values of combined detection of serum and glucocorticoid induced protein kinase 1(SGK1)and human epididymis protein 4(HE4)in the diagnosis and prognosis prediction of sepsis myocardial injury patients.Methods From September 2019 to September 2022,total 152 patients with sepsis were collected as study subjects.According to cardiac troponin T(cTnT)in patients,they were separated into myocardial injury group(n=66)and non myocardial injury group(n=86).Myocardial injury patients were also grouped into good prognosis group(n=43)and poor prognosis group(n=23)based on their prognosis after 28 days of treatment.Enzyme-linked immunosorbent assay(ELISA)was applied to detect serum SGK1 and HE4 in each group,and general data of myocardial injury group and non myocardial injury group were compared.Pearson method was applied to analyze the correlation between serum SGK1 and HE4 in patients with sepsis.Logistic regression was applied to analyze the relevant factors that affected the occurrence of myocardial injury in sepsis patients.Receiver operating characteristic(ROC)curve was applied to evaluate predictive value of serum SGK1,HE4,and their combination in predicting the prognosis of patients with sepsis myocardial injury.Results Serum SGK1 and HE4 in myocardial injury group were higher than those in non myocardial injury group(P<0.05).There were no statistically obvious differences in gender composition,age,body mass index,presence of coronary heart disease,systolic blood pressure,heart rate,respiration,and serum lactate between myocardial injury group and non myocardial injury group(P>0.05),while differences in serum albumin,urea nitrogen,left ventricular ejection fraction,and cTnT were statistically obvious(P<0.05).Pearson method analysis showed a positive correlation between serum SGK1 and HE4 in patients with sepsis(P<0.05).Logistic regression analysis showed that urea nitrogen,cTnT,serum SGK1 and HE4 were risk factors for myocardial injury in sepsis patients,while serum albumin and left v

关 键 词：脓毒症心肌损伤 血清糖皮质激素诱导激酶1 人附睾蛋白4 病情诊断 预后 

分 类 号：R542.2[医药卫生—心血管疾病]