血清硫氧还蛋白1对脓毒症患者预后的评估价值研究

Study on value of serum thioredoxin-1 in evaluating prognosis of patients with sepsis

目的检测脓毒症患者血清硫氧还蛋白1(thioredoxin-1,Trx-1)的水平,并探讨其对脓毒症患者预后的评估价值。方法采用前瞻性研究方法,选取2020年1月—2021年1月本院ICU收治的81例脓毒症患者,根据入院后28 d的预后分为生存组(52例)和死亡组(29例)。收集所有研究对象的临床资料,采用酶联免疫吸附法检测血清Trx-1水平,受试者工作特征曲线(ROC)分析Trx-1对脓毒症预后的评估价值。结果生存组患者血清Trx-1中位数P_(50)(P_(25)~P_(75))为13.23(7.15~24.06)ng/mL,而死亡组Trx-1为52.49(34.94~75.56)ng/mL,差异有统计学意义(Z=-6.059,P<0.001)。Trx-1预测脓毒症患者28 d预后的ROC曲线下面积(AUC)为0.908(95%CI:0.843~0.973,P<0.001),最佳截断值为33.44 ng/mL,敏感度和特异度分别为82.76%和92.31%。结论血清Trx-1水平对脓毒症患者28 d的预后具有良好的预测价值,有潜力成为评估脓毒症患者预后的生物标志物。

Objective To detect the serum level of thioredoxin-1(Trx-1)in patients with sepsis,and investigate its prognostic value for patients with sepsis.Methods Totally 81 sepsis patients admitted to the intensive care unit(ICU)of the First People's Hospital of Yancheng City between January 2020 and January 2021 were recruited into this prospective study.All the patients were divided into a survival group(n=52)and a death group(n=29)according to the prognosis of the patients at 28 days after admission.The clinical data of all the subjects were collected.The serum Trx-1 level was detected by enzyme-linked immunosorbent assay,and the receiver operating characteristic curve(ROC)was used to analyze the prognostic value of Trx-1 for sepsis.Results The serum Trx-1 level of patients in the survival group was 13.23(7.15-24.06)ng/mL,while the serum Trx-1 level in the death group was 52.49(34.94-75.56)ng/mL,and there was a significant difference between the two groups(Z=-6.059,P<0.001).The area under the ROC curve(AUC)of Trx-1 predicting 28-day death of sepsis was 0.908(95%CI:0.843-0.973,P<0.001),the best cut-off point was 33.44 ng/mL,and the sensitivity and specificity were 82.76%and 92.31%,respectively.Conclusion The serum Trx-1 level has a good predictive value for the 28-day prognosis of patients with sepsis,and may be a potential biomarker for evaluating the prognosis of sepsis.