脓毒症心肌损伤中NLRC4、DPP3及caspase-3表达水平的变化及其对预后的评估价值  

Changes in the expression levels of NLRC4,DPP3,and caspase-3 in sepsis induced myocardial injury and their prognostic value

作　　者：耿红玉 张红波 安辉[1] 秦延军[3] GENG Hong-yu;ZHANG Hong-bo;AN Hui(Department of Intensive Care Medicine,Baoding First Central Hospital,Baoding Hebei 071000,China;General Surgery,Baoding First Central Hospital,Baoding Hebei 071000,China)

机构地区：[1]保定市第一中心医院重症医学科,河北保定071000 [2]保定市第一中心医院普通外科,河北保定071000 [3]河北医科大学第三医院急诊科,河北石家庄050051

出　　处：《临床和实验医学杂志》2025年第6期573-576,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省卫健委医学科学研究课题计划项目(编号:20210256);保定市科技计划项目(编号:2441ZF228)。

摘　　要：目的观察脓毒症心肌损伤患者核苷酸结合寡聚化结构域样受体蛋白4(NLRC4)、二肽基肽酶Ⅲ(DPP3)及胱天蛋白酶3(caspase-3)表达水平的变化情况及对预后的评估价值。方法回顾性选取保定市第一中心医院2022年1月至2024年1月收治的150例脓毒症患者作为研究对象,根据有无合并心肌损伤将患者分为合并心肌损伤组(n=55)与未合并心肌损伤组(n=95)。比较两组患者的一般资料(年龄、性别、体重指数、高血压及感染部位)、实验室指标[肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)、N末端B型利钠肽原(NT-proBNP)]及NLRC4、DPP3、caspase-3水平,通过Pearson相关性分析对实验室指标与NLRC4、DPP3及caspase-3的相关性进行分析。根据脓毒症心肌损伤患者预后情况将其分为存活组(n=34)与死亡组(n=21),比较两组患者的NLRC4、DPP3及caspase-3水平。绘制受试者操作特征(ROC)曲线,分析单一指标及联合检测对患者预后的评估价值。结果两组患者的年龄、性别构成比、体重指数、高血压占比及感染部位比较,差异均无统计学意义(P>0.05)。合并心肌损伤组患者NT-proBNP、CK-MB、cTnI、NLRC4、DPP3、caspase-3水平分别为(2683.25±244.26)pg/mL、(14.34±2.65)ng/mL、(0.89±0.15)ng/mL、(6.93±0.52)ng/mL、(4.92±0.38)mg/L、(5.15±0.42)pg/mL,均高于未合并心肌损伤组[(1695.29±221.63)pg/mL、(9.47±1.14)ng/mL、(0.46±0.12)ng/mL、(5.72±0.28)ng/mL、(3.66±0.47)mg/L、(3.82±0.28)pg/mL],差异均有统计学意义(P<0.05)。Pearson相关性分析结果显示,NT-proBNP、CK-MB、cTnI与NLRC4、DPP3、caspase-3均呈现明显正相关(P<0.05)。死亡组患者的NLRC4、DPP3、caspase-3水平分别为(7.83±0.37)ng/mL、(6.42±0.26)mg/L、(6.25±0.36)pg/mL,均高于存活组[(5.47±0.56)ng/mL、(4.16±0.27)mg/L、(4.37±0.28)pg/mL],差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,NLRC4、DPP3、caspase-3水平联合检测评估患者预后的曲线下面积为0.952,敏感度为Objective To observe the changes in the expression levels of nucleotide binding oligomerization domain like receptor protein 4(NLRC4),dipeptidyl peptidaseⅢ(DPP3),and caspase-3 in patients with sepsis induced myocardial injury,and evaluate their prognostic value.Methods A total of 150 patients with sepsis admitted to Baoding First Central Hospital from January 2022 to January 2024 were retrospectively selected as the study objects,and they were divided into the myocardial injury group(n=55)and the non-myocardial injury group(n=95)according to whether they had myocardial injury.The general data(age,sex,body mass index,hypertension and site of infection),laboratory indicators[creatine kinase MB(CK-MB),troponin I(cTnI),N-terminal B-type natriuretic peptide(NT-proBNP)]and NLRC4,DPP3 and caspase-3 levels of the two groups were compared,and the correlation between laboratory indicators and NLRC4,DPP3 and caspase-3 was analyzed by Pearson correlation analysis.According to the prognosis of sepsis induced myocardial injury patients,they were divided into the survival group(n=34)and the death group(n=21).NLRC4,DPP3 and caspase-3 levels of the two groups were compared.The receiver operation characteristic(ROC)curve was drawn to analyze the value of single index and combined detection in evaluating the prognosis of patients.Results The levels of NT-proBNP,CK-MB,cTnI,NLRC4,DPP3 and caspase-3 in patients of myocardial injury group were(2683.25±244.26)pg/mL,(14.34±2.65)ng/mL,(0.89±0.15)ng/mL,(6.93±0.52)ng/mL,(4.92±0.38)mg/L and(5.15±0.42)pg/mL,respectively,which were higher than those in the non-myocardial injury group[(1695.29±221.63)pg/mL,(9.47±1.14)ng/mL,(0.46±0.12)ng/mL,(5.72±0.28)ng/mL,(3.66±0.47)mg/L,(3.82±0.28)pg/mL],and the differences were statistically significant(P<0.05).The results of the Pearson correlation analysis showed that NT-proBNP,CK-MB and cTnI were significantly positively correlated with NLRC4,DPP3 and caspase-3(P<0.05).The levels of NLRC4,DPP3 and caspase-3 in the death group were(7.83±0.37

关 键 词：脓毒症 肌钙蛋白 预后 心肌损伤 核苷酸结合寡聚化结构域样受体蛋白4 二肽基肽酶Ⅲ 胱天蛋白酶3 

分 类 号：R54[医药卫生—心血管疾病]