血清标志物的变化与脓毒症患者SOFA评分的相关性及临床意义

Correlation Between Changes of Serum Markers and SOFA Score in Patients with Sepsis and its Clinical Significance

目的:分析血清内皮细胞特异分子-1(ESM-1)、微小核糖核酸-155-5p(miR-155-5p)水平变化与脓毒症患者预后的相关性。方法:选取福建医科大学附属第一医院2019年4月至2021年2月收治的脓毒症患者122例,根据病情严重程度分为三组,依次为普通脓毒症组(52例)、严重脓毒症组(39例)、脓毒症休克组(31例),另选取同期健康体检者30例为对照组,均抽取空腹静脉血,以酶联免疫法检测血清ESM-1水平,以逆转录聚合酶链反应法检测miR-155-5p水平,比较四组血清ESM-1、miR-155-5p及序贯器官衰竭评分(SOFA),并比较不同SOFA脓毒症患者血清ESM-1、miR-155-5p水平,并分析相关性。结果:四组血清ESM-1、miR-155-5p及SOFA比较差异有统计学意义(P<0.05),且脓毒症休克组>严重脓毒症组>普通脓毒症组>对照组;不同SOFA脓毒症患者血清ESM-1、miR-155-5p比较,差异具有统计学意义(P<0.05),且SOFA越高,血清ESM-1、miR-155-5p水平越高;脓毒症患者SOFA与血清ESM-1、miR-155-5p均呈正相关关系。结论:ESM-1水平提高可促使趋化因子富集而加大血管内皮损伤,miR-155-5p高水平表达可诱导免疫失衡、导致氧化还原反应异常,二者均与脓毒症患者预后关系密切,且高水平表达提示患者病情较严重。

Objective To analyze the correlation between the changes of serum endothelial cell-specific molecule-1(ESM-1)and micro ribonucleic acid-155-5p(miR-155-5p)levels and the prognosis of patients with sepsis.Methods A total of 122 patients with sepsis admitted to the First Affiliated Hospital of Fujian Medical University from April 2019 to February 2021 were selected and divided into three groups according to the severity of their disease:ordinary sepsis group with 52 cases,severe sepsis group with 39 cases and septic shock group with 31 cases;Another 30 healthy subjects who underwent physical examination during the same period were selected as the control group.Fasting venous blood was taken from all groups,serum ESM-1 level was detected by enzyme-linked immunosorbent assay(ELISA),and the miR-155-5p level was detected by reverse transcription polymerase chain reaction(RT-PCR).Moreover,serum ESM-1,miR-155-5p and sequential organ failure assessment(SOFA)of the four groups were compared,the serum levels of ESM-1 and miR-155-5p in sepsis patients with different SOFA were compared,and their correlation was analyzed.Results There were statistically significant differences in serum ESM-1,miR-155-5p and SOFA among the four groups(P<0.05),and the order of levels among the four groups was septic shock group>severe sepsis group>normal sepsis group>control group.Statistically significant differences could be observed in the comparison of serum ESM-1 and miR-155-5p in sepsis patients with different SOFA(P<0.05),and the higher SOFA was,the higher serum ESM-1 and miR-155-5p levels were.SOFA was positively correlated with serum ESM-1 and miR-155-5p in patients with sepsis.Conclusion Increased levels of ESM-1 can promote the accumulation of chemokines and increase vascular endothelial damage,while high-level expression of miR-155-5p can induce immune imbalance and lead to abnormal redox reactions,both of which are closely related to the prognosis of patients with sepsis,and a high level of expression indicates more severe disease in patients.