血浆外泌体S100P蛋白对中暑患者的诊断价值

Clinical diagnostic value of plasma exosomes S100P protein in patients with heatstroke

目的探讨中暑患者血浆外泌体S100P蛋白含量的变化,并评价其诊断价值。方法选取2016年6月-2018年6月于南部战区总医院就诊的中暑患者30例,选取本院体检中心健康人群15例作为对照。采集静脉血,采用聚乙二醇沉淀法提取血浆外泌体并进行鉴定;采用ELISA法检测血浆外泌体S100P蛋白的含量;分析患者血浆外泌体S100P水平平均值与临床指标以及病情严重程度的相关性;绘制受试者工作特征(ROC)曲线,评估血浆外泌体S100P评价中暑及其病情严重程度的效能。结果与健康人群比较,中暑患者血浆外泌体S100P水平明显升高[(195.89±131.97) pg/mlvs.(1163.62±747.15) pg/ml,P<0.001],且重度中暑患者较轻度中暑患者升高更明显[(553.63±311.85) pg/ml vs.(1570.28±672.03) pg/ml,P<0.001]。血浆外泌体S100P水平与中暑严重程度具有明显相关性,其与APACHEⅡ评分、SOFA评分、MODS评分的相关系数r分别为0.888(P<0.001)、0.901(P<0.001)、0.887(P<0.001)。血浆外泌体S100P诊断中暑的ROC曲线下面积为0.931(95%CI0.857~1.000,P<0.001),评估中暑严重程度的ROC曲线下面积为0.956(95%CI 0.890~1.000,P<0.001)。结论血浆外泌体S100P可作为中暑诊断的潜在标志物,且能够反映中暑的严重程度。

Objective To investigate the plasma exosome S100P levels in patients with heatstroke and evaluate its clinical diagnostic value. Methods Thirty heatstroke patients were selected from June 2016 to June 2018 in the General Hospital of Southern Theatre Command of PLA, and 15 healthy people in the Physical Examination Center of our hospital were selected as control. The venous blood was collected, followed by plasma exosomes extraction using polyethylene glycol precipitation. The plasma exosome S100P was quantified by ELISA. The correlation analysis between plasma exosomal S100P, clinical indicators, and disease severity was performed. The receiver operating characteristic (ROC) curve was analyzed to evaluate the efficacy of plasma exosome S100P in diagnosing heatstroke. Results The level of plasma exosomes S100P in patients with heatstroke significantly increased [healthy people vs. heatstroke patients:(195.89±131.97) pg/ml vs.(1163.62±747.15) pg/ml, P<0.001], and the level of plasma exosome S100P was significantly correlated with the severity of heatstroke patients [mild heatstroke patients vs. severe heatstroke patients (553.63±311.85) pg/ml vs.(1570.28±672.03) pg/ml, P<0.001]. The correlation coefficients r of plasma exosome S100P with APACHE Ⅱ score, SOFA score and MODS score were 0.888, 0.901, and 0.887, respectively (P<0.001). The area under the ROC curve for the diagnosis of heatstroke by plasma exosomal S100P was 0.931 (95%CI 0.857-1.000, P<0.001). The area under the ROC curve of plasma exosomal S100P for assessing the severity of heatstroke was 0.956 (95%CI 0.890-1.000, P<0.001). Conclusion The level of plasma exosomal S100P correlates with severity of heatstroke and can be used as a potential marker for diagnosis and prognosis of heatstroke.