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血清高迁移率族蛋白B1、可溶性髓样细胞触发受体样转录因子-1与脓毒症急性肺损伤的关系

Relationships between serum high mobility group protein B1, soluble triggering receptor expressed on myeloid cells-like transcript 1 and acute lung injury induced by sepsis

    摘要
  • 摘要:
      目的  探讨血清高迁移率族蛋白B1（HMGB1）、可溶性髓样细胞触发受体样转录因子-1（sTLT-1）水平与脓毒症患者急性肺损伤（ALI）的关系。
      方法  选取脓毒症患者160例为研究对象，根据住院期间是否出现ALI分为ALI组（47例）和非ALI组（113例）。收集患者一般资料，采用酶联免疫吸附法检测血清HMGB1、sTLT-1水平。采用Pearson法分析脓毒症ALI患者血清HMGB1、sTLT-1水平与相关指标的关系，采用多因素Logistic回归分析观察探讨脓毒症ALI的危险因素，采用受试者工作特征曲线（ROC）分析观察HMGB1、sTLT-1水平对脓毒症患者发生ALI的预测价值。
      结果  ALI组氧合指数pa（O2）/FiO2低于非ALI组，序贯器官衰竭（SOFA）评分、C反应蛋白（CRP）、N-端脑利钠肽前体（NT-proBNP）及血清HMGB1、sTLT-1水平均高于非ALI组，差异有统计学意义（P < 0.05）。脓毒症ALI患者血清HMGB1、sTLT-1水平与pa（O2）/FiO2呈负相关，与SOFA评分、CRP、NT-proBNP呈正相关（P < 0.05）。pa（O2）/FiO2、SOFA评分及血清HMGB1、sTLT-1水平均是影响脓毒症ALI发生的危险因素（P < 0.05）。血清HMGB1、sTLT-1水平联合预测脓毒症患者发生ALI的曲线下面积为0.910，联合预测的敏感度和特异度高于血清HMGB1、sTLT-1水平单独预测。
      结论  脓毒症ALI患者血清HMGB1、sTLT-1水平升高，可作为判断ALI发生的潜在血清指标。

     

    Abstract:
      Objective  To investigate relationships between the levels of high mobility group protein B1 (HMGB1), soluble triggering receptor expressed on myeloid cells (TREM)-like transcript 1 (sTLT-1) and acute lung injury (ALI) induced by sepsis.
      Methods  A total of 160 patients with sepsis were selected as research objects, according to whether ALI occurred during hospitalization, they were divided into ALI group (47 cases) and non-ALI group (113 cases). General information was collected, and HMGB1 as well as sTLT-1 levels were measured by enzyme-linked immunosorbent assay. Pearson method was used to analyze the relationships between serum HMGB1, sTLT-1 levels and related indicators in patients with ALI induced by sepsis. Multivariate Logistic regression analysis was used to explore the risk factors of ALI induced by sepsis; receiver operator characteristic (ROC) curve was used to analyze the predictive value of serum HMGB1 and sTLT-1 levels for ALI in sepsis patients.
      Results  The oxygenation indexpa(O2)/FiO2 of the ALI group was significantly lower than that of the non-ALI group, and the levels of sequential organ failure assessment (SOFA), C-reactive protein (CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), serum HMGB1 and sTLT-1 were significantly higher than those of the non-ALI group (P < 0.05). The levels of HMGB1 and sTLT-1 were negatively correlated with pa(O2)/FiO2, and positively correlated with SOFA score, CRP and NT-proBNP (P < 0.05). The level of pa(O2)/FiO2, SOFA score and serum levels of HMGB1 and sTLT-1 were risk factors for ALI induced by sepsis (P < 0.05). The area under the curve of serum HMGB1 and sTLT-1 levels in predicting the occurrence of ALI in sepsis patients was 0.910. The sensitivity and specificity of combined prediction were higher than that of serum HMGB1 or STT-1 alone.
      Conclusion  The serum levels of HMGB1 and sTLT-1 are increased in patients with sepsis ALI, and they can be used as potential serum markers to judge the occurrence of ALI.

     

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