Yes相关蛋白在脓毒症患者PBMC中的表达及意义

Expression and significance of Yes-associated protein in PBMC of sepsis patients

目的探讨Yes相关蛋白(YAP)在脓毒症患者外周血单个核细胞(PBMC)中的表达情况及临床意义。方法检测65例脓毒症患者(脓毒症组)和36名健康志愿者(对照组)PBMC中YAP mRNA的表达水平。根据28 d临床结局将脓毒症组分为死亡亚组(26例)和存活亚组(39例),比较2个亚组的急性生理学及慢性健康状况评分系统(APACHEⅡ)评分和PBMC中YAP mRNA的表达水平,采用Pearson相关分析两类指标的相关性,并用受试者工作特征(ROC)曲线分析YAP mRNA表达水平预测脓毒症患者预后的效果。结果脓毒症组和对照组一般情况具可比性(P> 0.05)。脓毒症组PBMC中YAP mRNA表达水平高于对照组(P <0.05)。死亡亚组患者入院时的APACHEⅡ评分及PBMC中YAP mRNA表达水平均高于存活亚组(P <0.05)。脓毒症患者PBMC中YAP mRNA表达水平与APACHEⅡ评分呈正相关(r=0.660,P <0.05),YAP mRNA表达水平预测脓毒症患者预后的ROC曲线的曲线下面积为0.691,灵敏度和特异度均为0.692。结论脓毒症患者PBMC中的YAP表达水平高于健康者且与病情严重程度呈正相关,有助于判断患者的病情严重程度与预测预后。

Objective To investigate the expression and clinical significance of Yes-associated protein(YAP) in peripheral blood mononuclear cells(PBMC) of sepsis patients.Methods The expression levels of YAP mRNA in PBMC were detected in 65 sepsis patients(sepsis group) and 36 healthy volunteers(control group).According to the clinical outcome at day 28,the sepsis group was divided into death subgroup(26 cases) and survival subgroup(39 cases).The acute physiology and chronic health status scoring system(APACHE Ⅱ) score and YAP mRNA expression level in PBMC were compared in two groups.Pearson correlation was used to analyze the correlation between two types of indices.Receiver-operating characteristic curve(ROC) was used to analyze the effect of YAP mRNA expression levels in predicting prognoses of sepsis patients.Results The general conditions of sepsis group and control group were comparable(P> 0.05).The expression level of YAP mRNA in PBMC in sepsis group was higher than that in control group(P <0.05).Patients in death subgroups had higher APACHE Ⅱ scores and YAP mRNA expression levels in PBMC on admission to hospital than those in survival subgroup(P <0.05).The expression level of YAP mRNA in sepsis patients was positively correlated with the APACHE Ⅱ score(r=0.660,P <0.05).The area under the curve of ROC that predicts prognoses of sepsis patients based on YAP mRNA expression levels was 0.691.Both the sensitivity and the specificity were 0.692.Conclusion The YAP expression levels in PBMC were higher in sepsis patients than in healthy subjects and possitively correlated with the severity of sepsis,which was helpful to judge the severity of sepsis and predict the prognoses of patients.