铁死亡相关基因表达水平与脓毒症心肌功能障碍及预后的相关性  

Correlation between iron death-related gene expression level and myocardial dysfunction and prognosis in sepsis

作　　者：段彤 吴奇 刘惠 DUAN Tong;WU Qi;LIU Hui(Department of Emergency,Changsha First Hospital,Changsha 410005,Hunan,China)

机构地区：[1]长沙市第一医院急诊科,湖南长沙410005

出　　处：《实用医学杂志》2025年第6期846-851,共6页The Journal of Practical Medicine

基　　金：湖南省卫生健康委科研计划项目(编号:202202053728)。

摘　　要：目的探讨铁死亡相关基因表达水平与脓毒症患者心肌功能障碍及预后的相关性。方法纳入2023年5月至2024年8月本院收治的85例脓毒症患者,根据心肌功能障碍发生情况分为障碍组(39例)和非障碍组(46例)。收集患者年龄、原发疾病等临床资料;采集肺组织标本,检测细胞色素p450氧化还原酶(POR)、溶质载体家族7成员5(SLC7A5)和信号转导和转录激活因子3(STAT3)铁死亡相关基因的mRNA表达水平。通过多因素logistic回归分析铁死亡相关基因表达水平与脓毒症心肌功能障碍(SIMD)的相关性;绘制Kaplan-Meier生存曲线分析铁死亡相关基因表达水平与脓毒症患者预后的相关性。结果障碍组脓毒症患者男性占比、年龄和POR、SLC7A5及STAT3表达水平均高于非障碍组(P<0.05)。在排除性别、年龄等混杂因素的干扰后,POR、SLC7A5及STAT3表达水平是SIMD的独立影响因素(P<0.05)。绘制ROC曲线显示,POR表达水平预测SIMD的AUC为0.677(95%CI:0.561~0.792),敏感度、特异度分别为87.20%、54.30%;SLC7A5表达水平预测SIMD的AUC为0.844(95%CI:0.749~0.939),敏感度、特异度分别为74.40%、93.50%;STAT3表达水平预测SIMD的AUC为0.690(95%CI:0.570~0.809),敏感度、特异度分别为69.20%、71.70%。随访期间,85例脓毒症患者中,有69例(81.18%)存活,16例(18.82%)死亡;绘制Kaplan-Meier生存曲线显示,POR、SLC7A5表达水平与脓毒症患者28 d生存率相关(χ^(2)=6.048/10.143,P<0.05),STAT3表达水平与脓毒症患者28 d生存率无显著关联(χ^(2)=2.149,P>0.05)。结论POR、SLC7A5及STAT3表达水平与SIMD密切相关,其中POR、SLC7A5表达水平与脓毒症患者预后显著相关。Objective To examine the correlation between ferroptosis-related gene expression levels and myocardial dysfunction as well as prognosis in sepsis patients.Methods Eighty-five sepsis patients admitted to our hospital from May 2023 to August 2024 were categorized into two groups based on the presence of myocardial dysfunction:the impaired group(n=39)and the non-impaired group(n=46).The mRNA expression levels of cytochrome P450 oxidoreductase(POR),solute carrier family 7 member 5(SLC7A5),and signal transducer and activator of transcription 3(STAT3)were measured.Multivariate logistic regression analysis was conducted to examine the correlation between the expression levels of iron death-related genes and sepsis-induced myocardial dysfunction(SIMD).Kaplan-Meier survival curves were plotted to evaluate the relationship between the expression levels of iron death-related genes and the prognosis of sepsis patients.Results In patients with sepsis,the disorder group exhibited higher male proportions,age,and expression levels of POR,SLC7A5,and STAT3 compared to the non-disorder group(P<0.05).After adjusting for potential confounders such as gender and age,the expression levels of POR,SLC7A5,and STAT3 remained independent predictors of SIMD(P<0.05).The ROC curve analysis revealed that the AUC for POR expression in predicting SIMD was 0.677(95%CI:0.561~0.792),with a sensitivity of 87.20%and specificity of 54.30%.For SLC7A5,the AUC was 0.844(95%CI:0.749~0.939),with a sensitivity of 74.40%and specificity of 93.50%.STAT3 had an AUC of 0.690(95%CI:0.570~0.809),with a sensitivity of 69.20%and specificity of 71.70%.During the follow-up period,69 patients(81.18%)survived,while 16(18.82%)did not.Kaplan-Meier survival analysis indicated that POR and SLC7A5 expression levels were significantly associ-ated with the 28-day survival rate of septic patients(χ^(2)=6.048/10.143,P<0.05),whereas STAT3 expression showed no significant correlation(χ^(2)=2.149,P>0.05).Conclusion The expression levels of POR,SLC7A5 and STAT3 are closely related

关 键 词：铁死亡 脓毒症 心肌功能障碍 预后 相关性 

分 类 号：R692.5[医药卫生—泌尿科学]