血清GRP78、sCD163、miR-29a水平对重度烧伤患者并发脓毒症的预测价值  

Predictive value of serum GRP78,sCD163,and miR-29a levels in severe burn patients with concurrent sepsis

作　　者：张方 李丹 崔庆伟 ZHANG Fang;LI Dan;CUI Qingwei(Department of Burn Plastic Surgery,Huaihai Hospital Affiliated to Xuzhou Medical University(71st Army Military Hospital),Xuzhou,Jiangsu,China,221000;Department of TCM Rehabilitation Physiotherapy,Huaihai Hospital Affiliated to Xuzhou Medical University(71st Army Military Hospital),Xuzhou,Jiangsu,China,221000)

机构地区：[1]徐州医科大学附属淮海医院(陆军第七十一集团军医院)烧伤整形科,江苏徐州221000 [2]徐州医科大学附属淮海医院(陆军第七十一集团军医院)中医康复理疗科,江苏徐州221000

出　　处：《分子诊断与治疗杂志》2025年第3期581-584,共4页Journal of Molecular Diagnostics and Therapy

基　　金：江苏省老年健康科研项目(LKZ2022004)。

摘　　要：目的探讨血清葡萄糖调节蛋白78(GRP78)、可溶性血红蛋白清道夫受体(sCD163)、微小核糖核酸-29a(miR-29a)水平对重度烧伤患者并发脓毒症的预测价值。方法选取2021年1月至2024年1月陆军第七十一集团军医院收治的102例重度烧伤患者,根据是否并发脓毒症分为非脓毒症组(n=32)和脓毒症组(n=70)。比较两组血清GRP78、sCD163水平及miR-29a表达量,Logistic回归分析影响患者并发脓毒症的因素,受试者工作特征(ROC)曲线分析患者血清GRP78、sCD163水平和miR-29a的表达对并发脓毒症的预测效能。结果脓毒症组的总烧伤面积、GRP78、sCD163水平均高于非脓毒症组(P<0.05),脓毒症组的miR-29a表达量低于非脓毒症组(P<0.05)。Logistic回归分析结果显示,重度烧伤患者的总烧伤面积、血清GRP78、sCD163水平是并发脓毒症的危险因素(P<0.05),miR-29a的表达是并发脓毒症的保护因素(P<0.05)。ROC曲线分析显示,患者血清中GRP78、sCD163水平和miR-29a的表达量预测脓毒症并发的曲线下面积(AUC)分别为0.902、0.821、0.889,敏感度和特异度分别为0.814、0.937,0.543、0.969,0.771、0.937,联合预测的AUC为0.976,敏感度和特异度分别为0.943、0.967。结论重度烧伤并发脓毒症患者血清GRP78、sCD163水平升高,miR-29a表达量降低,均为脓毒症的危险因素,三者联合预测对脓毒症预后具有重要的预测价值。Objective To investigate the predictive value of serum glucose-regulated protein 78(GRP78),soluble hemoglobin scavenger receptor(sCD163),and microRibonucleic Acid-29a(miR-29a)levels in patients with severe burns complicating sepsis.Methods 102 patients with severe burns admitted to the 71st Army Group Military Hospital from January 2021 to January 2024 were selected and divided into the nonsepsis group(n=32)and the sepsis group(n=70)according to whether or not sepsis was complicated.Serum GRP78,sCD163 levels and miR-29a expression were compared between the two groups,logistic regression was used to analyze the factors affecting the patients'complication of sepsis,and subject work characteristics(ROC)curves were used to analyze the predictive efficacy of the patients'serum GRP78,sCD163 levels and miR-29a expression on complication of sepsis.Results The total burn area,GRP78,and sCD163 levels in the sepsis group were higher than those in the non-sepsis group(P<0.05),miR-29a expression was lower in the sepsis group compared to the non-sepsis group(P<0.05).Logistic regression analysis showed that total burn area,serum GRP78,and sCD163 levels in patients with severe burns were risk factors for sepsis complication(P<0.05),whereas miR-29a expression was a protective factor against sepsis(P<0.05).ROC curve analysis showed that the area under the curve(AUC)for predicting sepsis based on serum GRP78,sCD163 levels,and miR-29a expression were 0.902,0.821,and 0.889.The sensitivity and specificity were 0.814 and 0.937 for GRP78,0.543 and 0.969 for sCD163,and 0.771 and 0.937 for miR-29a.The combined prediction had an AUC of 0.976,with a sensitivity of 0.943 and a specificity 0.967.Conclusion Serum GRP78 and sCD163 levels are elevated and miR-29a expression is decreased in patients with severe burns complicating sepsis,all of which are risk factors for sepsis,and the combination of the three has an important predictive value for sepsis prognosis.

关 键 词：GRP78 sCD163 miR-29a 重度烧伤 脓毒症 炎症 

分 类 号：R73[医药卫生—肿瘤]