摘要
目的探究外周血多配体蛋白聚糖1(SDC-1)、血管生成素样蛋白4(ANGPTL4)、脂肪酸结合蛋白4(FABP4)对重症肺炎(SP)相关性脓毒症患者病情进展和预后的评估价值。方法选取2022年7月至2024年7月江苏省南京市江宁医院92例SP相关性脓毒症患者作为研究组,并选择同期健康体检的98名健康者为对照组;根据研究组患者30 d的死亡情况,分为死亡组41例、生存组51例。酶联免疫吸附法(ELISA)法测定外周血SDC-1、ANGPTL4、FABP4表达水平;通过Pearson分析,确定外周血SDC-1、ANGPTL4、FABP4表达水平与患者急性生理学和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分的关系;SP相关性脓毒症患者预后的风险因素通过多因素Logistic回归分析确定;绘制受试者工作特征(ROC)曲线分析外周血SDC-1、ANGPTL4、FABP4对SP相关性脓毒症患者预后的诊断价值。结果与对照组比较,研究组患者外周血SDC-1、ANGPTL4、FABP4水平明显升高(P<0.05);与生存组比较,死亡组患者外周血SDC-1、ANGPTL4、FABP4水平显著上升(P<0.05);与生存组比较,死亡组患者APACHEⅡ评分明显升高(P<0.05);SP相关性脓毒症患者外周血SDC-1、ANGPTL4、FABP4水平与APACHEⅡ评分呈正相关(P<0.05);SDC-1、ANGPTL4、FABP4、APACHEⅡ评分是SP相关性脓毒症患者死亡的危险因素(P<0.05);外周血SDC-1、ANGPTL4、FABP4联合诊断SP相关性脓毒症患者预后的曲线下面积(AUC)为0.980,联合诊断AUC优于单独诊断(Z=3.555、2.630、3.553,P<0.05)。结论SP相关性脓毒症患者外周血SDC-1、ANGPTL4、FABP4水平显著上升,与患者病情进展及预后有关,三者联合诊断患者预后具有一定价值,可以作为评估患者病情进展及预后的血清学标志物。
Objective To explore the value of peripheral blood syndecan-1(SDC-1),angiopoietin-like protein 4(ANGPTL4),and fatty acid-binding protein 4(FABP4)in evaluating the progression and prognosis of severe pneumonia(SP)-related sepsis patients.Methods From July 2022 to July 2024,92 patients diagnosed with SP-induced sepsis in Jiangning Hospital of Nanjing were included as the study group,and 98 healthy individuals who underwent health check-ups in our hospital were selected as the control group.According to the 30-day survival status,the study group was further divided into the death group(n=41)and the survival group(n=51).The levels of SDC-1,ANGPTL4,and FABP4 in peripheral blood were measured using ELISA.Pearson correlation analysis was used to determine the relationship between SDC-1,ANGPTL4,and FABP4 levels and APACHE II scores.Multivariate logistic regression analysis was applied to identify risk factors for poor prognosis in SP-induced sepsis patients,and the ROC curve was plotted to evaluate the diagnostic value of SDC-1,ANGPTL4,and FABP4 for prognosis.Results The levels of SDC-1,ANGPTL4,and FABP4 in the study group were significantly higher than those in the control group(P<0.05).The death group showed significantly higher peripheral blood levels of SDC-1,ANGPTL4,and FABP4 compared to the survival group(P<0.05).The APACHE II score in the death group was also significantly higher than that in the survival group(P<0.05).Levels of SDC-1,ANGPTL4,and FABP4 were positively correlated with APACHE II scores(P<0.05).Multivariate logistic regression analysis identified SDC-1,ANGPTL4,FABP4,and APACHE II scores as risk factors for mortality in SP-induced sepsis patients(P<0.05).The AUC for combined SDC-1,ANGPTL4,and FABP4 in predicting mortality in SP-induced sepsis patients was 0.980,significantly higher than that of individual markers(Z=3.555,2.630,3.553;P<0.05).Conclusion Levels of SDC-1,ANGPTL4,and FABP4 in peripheral blood are significantly elevated in SP-induced sepsis patients,and their combination has a certain value for predicting prognosis.They can serve as reliable serological markers for evaluating disease progression and prognosis.
作者
江雨
张士卿
袁欣怡
JIANG Yu;ZHANG Shiqing;YUAN Xinyi(Department of Emergency,Jiangning Hospital of Nanjing,Nanjing,Jiangsu 211100,China)
出处
《转化医学杂志》
2024年第9期1414-1419,共6页
Translational Medicine Journal
基金
江苏卫生健康职业学院科研项目(JKC202010)
南京医科大学科技发展基金项目(NMUB2019234)。
