脓毒症患者短期预后的影响因素及YAP联合STAT3检测的预测价值研究

Influencing Factors of Short-Term Prognosis in Patients with Sepsis and the Predictive Value of YAP Combined with STAT3

目的:研究脓毒症患者短期预后的影响因素及Yes相关蛋白(YAP)联合信号转导子和转录激活子3(STAT3)信使RNA(m RNA)检测的预测价值。方法:选择我院2019年3月~2021年1月收治的131例脓毒症患者,将其按照28d预后情况的差异分成死亡组以及生存组。比较两组各项基线资料,外周血单个核细胞YAP、STAT3 m RNA表达水平。采用多因素Logistic回归分析脓毒症患者短期预后的影响因素。此外,通过受试者工作特征(ROC)曲线分析外周血单个核细胞YAP、STAT3 m RNA表达预测脓毒症患者短期预后的效能。结果:死亡组患者的外周血单个核细胞YAP、STAT3 m RNA相对表达量均高于生存组患者(P<0.05)。死亡组年龄大于生存组,住院时间短于生存组,APACHEⅡ评分高于生存组,合并基础疾病、机械通气的患者比例高于生存组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,年龄、APACHEⅡ评分、合并基础疾病、机械通气以及外周血单个核细胞YAP、STAT3 m RNA表达水平是脓毒症患者短期预后的影响因素(P<0.05)。外周血单个核细胞YAP、STAT3m RNA联合检测预测脓毒症患者短期预后的曲线下面积为0.845,高于两指标单独检测的0.623、0.687。结论:脓毒症患者短期预后的影响因素包括年龄、APACHEⅡ评分、机械通气以及合并基础疾病等,联合检测外周血单个核细胞YAP、STAT3 m RNA表达对脓毒症患者短期预后具有一定预测价值。

Objective:To investigate the influencing factors of short-term prognosis in patients with sepsis and the predictive value of Yes-related protein(YAP)combined with signal transduction and transcription activator 3(STAT3)messenger RNA(m RNA)detection.Methods:131 patients with sepsis who were admitted to our hospital from March 2019 to January 2021 were selected.They were divided into death group and survival group according to the difference in prognosis at 28 days.The baseline data and the peripheral blood mononuclear cells YAP and STAT3 m RNA expression levels were compared between the two groups.Multivariate Logistic regression was used to analyze the influencing factors of short-term prognosis in patients with sepsis.In addition,the peripheral blood mononuclear cells YAP and STAT3 m RNA expression were analyzed by receiver operating characteristic(ROC)curve to predict the short-term prognosis of patients with sepsis.Results:The relative expressions of peripheral blood mononuclear cells YAP and STAT3m RNA in the death group patients were higher than those in the survival group patients(P<0.05).The age in the death group was longer than that in the survival group,the hospital stay was shorter than that in the survival group,the APACHEⅡscore was higher than that in the survival group,and the proportion of patients combined with basic diseases and mechanical ventilation were higher than those in the survival group,the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that age,APACHEⅡscore,combined with basic diseases,mechanical ventilation and expression levels of peripheral blood mononuclear cells YAP and STAT3 m RNA were adverse factors for the short-term prognosis of patients with sepsis(P<0.05).The area under the curve of the combined detection of peripheral blood mononuclear cells YAP and STAT3 m RNA to predict the short-term prognosis of patients with sepsis was 0.845,which was higher than 0.623 and 0.687 detected by the two indexes alone.Conclusions:The influencing factors of the short-term prognosis of patients with sepsis include age,APACHEⅡscore,mechanical ventilation and combined with diseases,etc.Combined detection of the m RNA expression of peripheral blood mononuclear cells YAP and STAT3 has certain predictive value for the short-term prognosis of patients with sepsis.