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

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[p;(O;)/FiO;]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p;(O;)/FiO;呈负相关,与SOFA评分、CRP、NT-proBNP呈正相关(P<0.05)。p;(O;)/FiO;、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。

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(s TLT-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 s TLT-1 levels were measured by enzyme-linked immunosorbent assay.Pearson method was used to analyze the relationships between serum HMGB1,s TLT-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 s TLT-1 levels for ALI in sepsis patients.Results The oxygenation index[p;(O;)/Fi O;]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 s TLT-1were significantly higher than those of the non-ALI group (P<0.05).The levels of HMGB1 and s TLT-1were negatively correlated with p;(O;)/Fi O;,and positively correlated with SOFA score,CRP and NT-proBNP (P<0.05).The level of p;(O;)/Fi O;,SOFA score and serum levels of HMGB1 and s TLT-1 were risk factors for ALI induced by sepsis (P<0.05).The area under the curve of serum HMGB1 and s TLT-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-1alone.Conclusion The serum levels of HMGB1 and s TLT-1 are increased in patients with sepsis ALI,and they can be used as potential serum markers to judge the occurrence of ALI.