JAK/STAT信号通路激活与结石术后感染性休克程度及转归的关系

Relationship between the activation of JAK/STAT signal pathway and the severity and outcomes of septic shock after calculus surgery

目的探究Janus激酶(JAK)/信号转导和转录激活因子3(STAT3)信号通路激活与结石术后感染性休克程度及转归的关系。方法将2015年10月-2020年10月西安市人民医院收治的结石术后感染性休克患者80例设为感染性休克组,另选取同期接受结石手术后未出现感染性休克的256例患者设为非感染性休克组。抽取各组患者外周静脉血,分离单个核细胞,检测JAK/STAT通路的表达,比较两组蛋白的表达差异,归纳结石术后感染性休克发生的影响因素。按照感染性休克严重程度,将患者分为轻度感染休克组、中度感染休克组和重度感染休克组,比较各组JAK/STAT通路表达的差异。按照感染性休克患者转归情况将患者分为生存组和死亡组,比较两组JAK/STAT通路表达的差异。结果与非感染性休克组相比,感染性休克组患者血清JAK/STAT信号通路的激活的水平显著增强,炎症因子白细胞介素-1(IL-1β)和肿瘤坏死因子-α(TNF-α)较高(P<0.05)。性别、糖尿病史和术前接受抗感染治疗是结石患者术后感染性休克的影响因素(P<0.05)。随着患者感染性休克严重程度的加重,血清JAK/STAT信号通路的激活水平增强,炎症因子IL-1β和TNF-α的含量也随之升高(P<0.05);与生存组相比,死亡组患者血清JAK/STAT信号通路的激活的水平增强,炎症因子IL-1β和TNF-α的含量也更高(P<0.05)。结论性别、糖尿病史和术前接受抗感染治疗是结石术后感染性休克的影响因素,JAK/STAT信号通路的激活与术后感染性休克严重程度及转归有关,血清中JAK/STAT水平越高,患者感染性休克程度越严重,转归情况越差。

OBJECTIVE To explore the relationship between the activation of Janus kinase(JAK)/signal transducer and activator of transcription 3(STAT3)signaling pathway and the severity and outcomes of septic shock after calculus surgery.METHODS A total of 80 patients with septic shock after calculus surgery treated in Xi′an People′s Hospital from Oct.2015 to Oct.2020 were selected as the septic shock group,and 256 patients who did not develop septic shock after calculus surgery during the same period were set as the non-septic shock group.Peripheral venous blood were drawn from patients in each group,mononuclear cells were isolated,the expressions of JAK/STAT pathway were detected,and the differences in protein expressions were compared between the two groups,and the influencing factors of septic shock after calculus surgery were summarized.According to the severity of septic shock,the patients were divided into mild septic shock group,moderate septic shock group and severe septic shock group,and the differences in JAK/STAT pathway expressions in each group were compared.By means of the prognosis of septic shock patients,the patients were divided into survival group and death group,and the differences in JAK/STAT pathway expressions were compared between the two groups.RESULTS Compared with the non-septic shock,the activation levels of serum JAK/STAT signaling pathway in the septic shock group were significantly enhanced,and the levels of inflammatory factors interleukin-1(IL-1β)and tumor necrosis factor-α(TNF-α)were also higher(P<0.05).The gender,history of diabetes mellitus and preoperative anti-infective treatment were the influencing factors of postoperative septic shock in patients with calculus(P<0.05).With the aggravation of severity of septic shock,the activation level of serum JAK/STAT signaling pathway was enhanced significantly and the levels of inflammatory factors IL-1βand TNF-αwere also increased(P<0.05).In addition,compared with the survival group,the activation level of serum JAK/STAT signal pathway was significantly risen,and the levels of IL-1βand TNF-αwere also higher in the death group(P<0.05).CONCLUSION Gender,history of diabetes mellitus and preoperative anti-infective treatment were the influencing factors of septic shock after calculus surgery.The activation of JAK/STAT signaling pathway was related to the severity and outcome of postoperative septic shock.The higher the levels of serum JAK/STAT,the more severe the septic shock and the worse theprognosis.