瘀毒内阻型脓毒症心肌损伤外周血中salusin-β、MCP-1表达水平及对预后的预测价值  

Expression levels of salusin-β and MCP-1 in peripheral blood of sepsis patients with blood stasis and endotoxin blockage-induced myocardial injury and their predictive value for prognosis

作　　者：柳彦佐 杨洞洞 LIU Yan-Zuo;YANG Dong-Dong(Department of Emergency Medicine,the First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine,Hangzhou 310006,Zhejiang,China)

机构地区：[1]浙江中医药大学附属第一医院急诊医学科,浙江杭州310006

出　　处：《吉林医学》2025年第4期813-817,共5页Jilin Medical Journal

基　　金：国家自然科学基金项目[项目编号:82104763]。

摘　　要：目的:探讨瘀毒内阻型脓毒症心肌损伤患者外周血中心血管活性肽salusin-β、单核趋化蛋白(MCP)-1的表达水平及对预后的预测价值。方法:选择瘀毒内阻型脓毒症患者100例,按照有无心肌损伤分为心肌损伤组(46例)和非心肌损伤组(54例)。并对心肌损伤患者进行随访,统计其结局。检测心肌肌钙蛋白(cTn)I、肌酸激酶同工酶(CK-MB)、N末端脑钠肽前体(NT-proBNP)、salusin-β、MCP-1等指标,并重点分析salusin-β、MCP-1对瘀毒内阻型脓毒症心肌损伤及预后的预测价值。结果:心肌损伤组cTnI、CK-MB、NT-proBNP、salusin-β、MCP-1水平显著高于非心肌损伤组,差异有统计学意义(P<0.001)。Logistic回归分析显示,cTnI、CK-MB、NT-proBNP、salusin-β、MCP-1均是瘀毒内阻型脓毒症心肌损伤的危险因素(P<0.05)。心肌损伤患者住院28 d内结局为死亡19例,存活27例。死亡组cTnI、CK-MB、NT-proBNP、salusin-β、MCP-1水平显著高于存活组,差异有统计学意义(P<0.05)。Logistic回归分析显示,cTnI、CK-MB、NT-proBNP、salusin-β、MCP-1均是瘀毒内阻型脓毒症心肌损伤患者死亡的危险因素(P<0.05)。salusin-β、MCP-1两项指标联合检测的曲线下面积(AUC)大于单独检测,两者联合检测对瘀毒内阻型脓毒症心肌损伤患者预后的诊断价值大于单独检测,差异有统计学意义(P<0.05)。结论:瘀毒内阻型脓毒症心肌损伤患者外周血中salusin-β和MCP-1水平显著升高,且该标志物不仅与心肌损伤的发生相关,还可以预测患者预后,且联合预测价值更大。Objective To investigate the expression levels of cardiovascular active peptide salusin-βand monocyte chemoattractant protein-1(MCP-1)in peripheral blood of sepsis patients with myocardial injury due to blood stasis and endotoxin blockage,and their predictive value for prognosis.Methods A total of 100 sepsis patients with blood stasis and endotoxin blockage admitted to Zhejiang Provincial Hospital of Traditional Chinese Medicine from September 2022 to March 2024 were enrolled.Patients were divided into myocardial injury(46 cases)and non-myocardial injury groups(54 cases)based on the incidence of myocardial injury.The myocardial injury group's patients were monitored to record their progress.Levels of cardiac troponin I(cTn I),creatine kinase-MB(CK-MB),N-terminal pro-brain natriuretic peptide(NT-proBNP),salusin-β,and MCP-1 were measured,with a focus on analyzing the predictive value of salusin-βand MCP-1 for myocardial injury and prognosis in sepsis patients with blood stasis and endotoxin blockage.Results Levels of cTn I,CK-MB,NT-proBNP,salusin-β,and MCP-1 were significantly higher in the myocardial injury group compared to the non-myocardial injury group(P<0.01).Logistic regression analysis revealed that cTn I,CK-MB,NT-proBNP,salusin-β,and MCP-1 were all risk factors for myocardial injury in sepsis patients with blood stasis and endotoxin blockage(P<0.05).Among the 46 sepsis patients with myocardial injury,19 died and 27 survived within 28 days of hospitalization.Levels of cTn I,CK-MB,NT-proBNP,salusin-β,and MCP-1 were significantly higher in the deceased group than in the survivors(P<0.05).Logistic regression analysis indicated that cTn I,CK-MB,NT-proBNP,salusin-β,and MCP-1 were also risk factors for mortality in sepsis patients with myocardial injury due to blood stasis and endotoxin blockage(P<0.05).In sepsis patients with myocardial injury from blood stasis and endotoxin blockage,the combined detection of salusin-βand MCP-1 had a larger area under the curve(AUC)than either marker alone,indicating tha

关 键 词：瘀毒内阻 脓毒症 心肌损伤 salusin-β 单核趋化蛋白(MCP)-1 

分 类 号：R54[医药卫生—心血管疾病]