血清SGK1、Metrnl水平评估脓毒症患者病情程度及预后的价值  

Evaluation of the value of serum SGK1 and Metrnl levels in assessing disease severity and prognosis in sepsis patients

作　　者：邹佳俊 郭健[1] 夏一春[1] 钱义明[1] Zou Jiajun;Guo Jian;Xia Yichun;Qian Yiming(Department of Emergency Medicine,Yueyang Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院急诊医学科,上海200437

出　　处：《疑难病杂志》2025年第4期385-390,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：上海市自然科学基金项目(23ZR1464200)。

摘　　要：目的探讨血清/糖皮质激素调节激酶1(SGK1)、镍纹蛋白样蛋白(Metrnl)水平评估脓毒症患者病情程度及预后的价值。方法选取2022年1月—2024年5月上海中医药大学附属岳阳中西医结合医院急诊医学科收治的脓毒症患者90例为脓毒症组。根据病情程度将患者分为普通脓毒症亚组68例和脓毒性休克亚组22例;再根据28 d预后情况将患者分为死亡亚组25例和存活亚组65例。另选取同期医院健康体检志愿者30例为健康对照组。采用酶联免疫吸附法检测血清SGK1、Metrnl水平;Pearson相关分析脓毒症患者血清SGK1、Metrnl水平与病情严重程度的相关性;多因素Logistic回归分析血清SGK1、Metrnl水平对脓毒症患者预后影响因素;受试者工作特征(ROC)曲线分析血清SGK1、Metrnl水平对脓毒症患者死亡预后的预测效能。结果脓毒症组血清SGK1水平低于健康对照组,血清Metrnl水平高于健康对照组(t/P=8.394/<0.001、10.994/<0.001);脓毒性休克亚组血清SGK1水平低于普通脓毒症亚组,血清Metrnl水平高于普通脓毒症亚组(t/P=4.444/<0.001、4.493/<0.001);脓毒症患者病情严重程度与血清SGK1水平呈负相关(r/P=-0.677/<0.001),与Metrnl水平呈正相关(r/P=0.685/<0.001);死亡亚组脓毒性休克比例、机械通气时间≥3 d比例、序贯器官衰竭评估(SOFA)评分、急性生理和慢性健康评估Ⅱ(APACHEⅡ)评分、血清Metrnl水平高于存活亚组,氧合指数、血清SGK1水平低于存活亚组(χ^(2)/t/P=10.399/0.001、7.123/0.008、3.208/0.003、4.234/<0.001、4.634/<0.001、4.156/<0.001、4.578/<0.001);多因素Logistic回归分析显示,血清Metrnl水平高为脓毒症患者死亡的独立危险因素[OR(95%CI)=1.028(1.008~1.049)],血清SGK1水平高为独立保护因素[OR(95%CI)=0.614(0.421~0.896)];血清SGK1、Metrnl水平单独及二者联合预测脓毒症患者死亡的曲线下面积(AUC)分别为0.791、0.783、0.886,二者联合的AUC大于单独预测(Z/P=2.122/0.034,2.382/0Objective To investigate the value of serum serum/glucocorticoid-regulated kinase 1(SGK1)and meteorin-like(Metrnl)levels in assessing the severity and prognosis of sepsis patients.Methods A total of 90 sepsis patients admitted to the Emergency Medicine Department of Yueyang Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,from January 2022 to May 2024 were enrolled as the observation group.Based on disease severity,patients were divided into the general sepsis subgroup(68 cases)and the septic shock subgroup(22 cases).According to the 28-day prognosis,they were further divided into the death subgroup(25 cases)and survival subgroup(65 cases).Additionally,30 healthy volunteers from the hospital's health checkup program during the same period were included as the healthy control group.Serum SGK1 and Metrnl levels were measured by enzyme-linked immunosorbent assay.The correlation between serum SGK1,Metrnl levels,and disease severity in sepsis patients was analyzed using Pearson correlation.Multivariate logistic regression was used to determine the effect of serum SGK1 and Metrnl levels on sepsis prognosis.Receiver operating characteristic(ROC)curves were constructed to evaluate the predictive performance of serum SGK1 and Metrnl levels for sepsis mortality prognosis.Results Serum SGK1 levels in the observation group were lower than those in the healthy control group,while serum Metrnl levels were higher(t/P=8.394/<0.001,10.994/<0.001).Serum SGK1 levels in the septic shock subgroup were lower than those in the general sepsis subgroup,while Metrnl levels were higher(t/P=4.444/<0.001,4.493/<0.001).The severity of sepsis was negatively correlated with serum SGK1 levels and positively correlated with Metrnl levels(r/P=-0.677/<0.001,0.685/<0.001).In the death subgroup,the proportions of septic shock and mechanical ventilation≥3 days,Sequential Organ Failure Assessment(SOFA)scores,Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)scores

关 键 词：脓毒症 血清/糖皮质激素调节激酶1 镍纹蛋白样蛋白 病情程度 预后 

分 类 号：R631[医药卫生—外科学] R446.112[医药卫生—临床医学]