摘要
目的探讨血清白细胞介素(IL)-35、前蛋白转化酶枯草溶菌素9(PCSK9)、微小核糖核酸-155(miR-155)联合检测对脓毒症继发多器官功能障碍综合征(MODS)的预测价值。方法选取2020年6月至2023年6月该院收治的脓毒症患者170例,根据28 d内是否继发MODS分为MODS组与无MODS组,比较两组临床资料及血清IL-35、PCSK9、miR-155,采用Pearson法及偏相关系数分析血清IL-35、PCSK9、miR-155与脓毒症病情程度及MODS发生风险的相关性,采用受试者工作特征(ROC)曲线评价血清IL-35、PCSK9、miR-155单独及联合检测对MODS的预测价值。另选取2023年7月至2024年7月该院脓毒症患者83例作为外部验证数据集进行外部验证。结果MODS组年龄、糖尿病者占比、快速序贯器官功能评估量表(qSOFA)评分、急性生理学与慢性健康状况评估量表Ⅱ(APACHEⅡ)评分及血清IL-35、PCSK9、miR-155水平高于无MODS组(P<0.05);Pearson法分析显示,血清IL-35、PCSK9、miR-155与qSOFA评分、APACHEⅡ评分呈正相关(P<0.05);偏相关系数分析显示,排除其他因素干扰后,血清IL-35、PCSK9、miR-155仍与MODS发生风险显著相关(P<0.05);ROC曲线分析显示,血清IL-35、PCSK9、miR-155联合预测MODS的曲线下面积(AUC)为0.907,大于各指标单独预测的AUC,且外部验证ROC曲线分析显示,三者联合预测的AUC为0.914。结论血清IL-35、PCSK9、miR-155表达与脓毒症继发MODS风险显著相关,联合检测对继发MODS具有一定预测价值,可作为临床预测MODS的辅助指标,从而指导临床防治。
Objective To explore the predictive value of combined detection of serum interleukin-35(IL-35),proprotein convertase subtilisin/kexin type 9(PCSK9),and microRNA-155(miR-155)for sepsis-induced multiple organ dysfunction syndrome(MODS).Methods A total of 170 patients with sepsis admitted in the hospital from June 2020 to June 2023 were selected.Patients were divided into MODS group and non-MODS group according to whether they developed secondary MODS within 28 days.Clinical data and serum levels of IL-35,PCSK9,and miR-155 were compared between the two groups.Pearson method and partial correlation coefficient were used to analyze the correlation between serum IL-35,PCSK9,and miR-155 and the severity of sepsis and the risk of MODS,and receiver operating characteristics(ROC)curve was used to evaluate the predictive value of serum IL-35,PCSK9,and miR-155 alone and in combination for MODS.In addition,83 patients with sepsis in the hospital from July 2023 to July 2024 were selected as external validation data sets for external validation.Results Age,percentage of patients with diabetes mellitus,quick sequential organ function assessment scale(qSOFA)score,acute physiology and chronic health status evaluation scaleⅡ(APACHEⅡ)score,and serum IL-35,PCSK9,and miR-155 levels in the MODS group were higher than those in the non-MODS group(P<0.05).Pearson method showed that serum IL-35,PCSK9,and miR-155 were positively correlated with qSOFA score and APACHEⅡscore(P<0.05).Partial correlation coefficient analysis showed that after excluding other factors,serum IL-35,PCSK9,and miR-155 were still significantly associated with the risk of MODS(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of the combination of serum IL-35,PCSK9,and miR-155 for predicting MODS was 0.907,which was greater than the AUC of each indicator alone.External validation ROC analysis showed that the AUC of combined detection of the three was 0.914.Conclusion The expression of serum IL-35,PCSK9,and miR-155 is significantly associated with the risk of sepsis-induced MODS.Combined detection has certain predictive value for the secondary development of MODS,and could be used as auxiliary indicators for clinical prediction for MODS,thereby guiding clinical prevention and treatment.
作者
张梅香
左志刚
刘秀娟
ZHANG Meixiang;ZUO Zhigang;LIU Xiujuan(Department of Critical Care Medicine,the First Hospital of Qinhuangdao,Qinhuangdao,Hebei 066000,China)
出处
《国际检验医学杂志》
2025年第18期2231-2236,共6页
International Journal of Laboratory Medicine
基金
河北省中医药管理局中医药类科研计划项目(2024150)
秦皇岛市科学技术研究与发展计划项目(202004A118)。
