感染性休克患者血清NFL、sNRG-1水平与疾病转归的关系

Relationship between serum NFL,sNRG-1 levels and disease outcome in patients with septic shock

目的 探讨感染性休克患者血清神经丝蛋白轻链(NFL)、可溶性神经调节蛋白-1(sNRG-1)水平与疾病转归的关系。方法 选择2019年1月至2022年5月海南医学院第二附属医院收治的121例感染性休克患者作为研究对象,根据疾病转归情况将其分为死亡组(42例)和生存组(79例)。所有患者入院后24 h内采用酶联免疫吸附试验检测血清NFL、sNRG-1水平。分析比较各组血清NFL、sNRG-1水平差异,采用受试者工作特征(ROC)曲线评估血清NFL、sNRG-1对感染性休克患者疾病转归的预测价值,多因素Logistic回归分析影响感染性休克患者疾病转归的相关因素。结果 死亡组血清NFL水平均明显高于生存组(P<0.05),sNRG-1水平明显低于生存组(P<0.05)。ROC曲线分析显示,血清NFL预测感染性休克患者疾病转归的曲线下面积(AUC)为0.775,最佳截断值为2.36 pg/mL,灵敏度及特异度分别为92.83%、53.16%;血清sNRG-1预测感染性休克患者疾病转归的AUC为0.859,最佳截断值为2.17 ng/L,灵敏度及特异度分别为92.83%、65.82%;血清NFL联合sNRG-1预测感染性休克患者疾病转归的AUC为0.919,灵敏度及特异度分别为85.71%、86.08%。多因素Logistic回归分析发现,血清NFL、sNRG-1水平,以及序贯器官功能衰竭(SOFA)评分、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分均为影响感染性休克患者疾病转归的独立危险因素(P<0.05)。结论 血清NFL、sNRG-1水平检测在感染性休克患者疾病转归预测中均具有重要意义,二者联合检测对感染性休克患者疾病转归具有更高的预测价值。

Objective To explore the relationship between serum neurofilament protein light chain(NFL),soluble neuroregulatory protein-1(sNRG-1)levels and disease outcome in patients with septic shock.Methods Totally 121 patients with septic shock admitted to the hospital from January 2019 to May 2022 were selected and divided into death group(42 cases)and survival group(79 cases)according to the outcome of the disease.The levels of serum NFL and sNRG-1 were measured by enzyme-linked immunosorbent assay within 24 hours after admission.The differences in serum NFL and sNRG-1 levels among the groups were analyzed and compared,and the predictive value of serum NFL and sNRG-1 on the disease outcome of patients with septic shock was evaluated by receiver operating characteristic(ROC)curve.Multivariate Logistic regression was used to analyze the related factors affecting the disease outcome of patients with septic shock.Results The level of serum NFL in the death group was higher than that in the survival group(P<0.05),and the level of sNRG-1 was lower than that in the survival group(P<0.05).The area under the curve(AUC)of serum NFL predicting the disease outcome of patients with septic shock was 0.775,the cut-off value was 2.36 pg/mL,and the sensitivity and specificity were 92.83%and 53.16%.The AUC of serum sNRG-1 in predicting the disease outcome of patients with septic shock was 0.859,the cut-off value was 2.17 ng/L,and the sensitivity and specificity were 92.83%and 65.82%.The AUC of serum NFL combined with sNRG-1 in predicting the disease outcome of patients with septic shock was 0.919,and the sensitivity and specificity were 85.71%and 86.08%.Serum NFL,sNRG-1,SOFA score,APACHEⅡscore were all independent risk factors affecting the disease outcome of patients with infectious shock(P<0.05).Conclusion The levels of serum NFL and sNRG-1 are of great significance in the prediction of disease outcome in patients with septic shock,and the combination of serum NFL and sNRG-1 has better predictive value for the disease outcome in patients with septic shock.