脓毒症患者血清泛素特异性蛋白酶13和组织因子水平与预后的相关性分析

Correlation Between Serum Ubiquitin-Specific Protease 13 and Tissue Factor and Prognosis in Patients with Sepsis.

目的探究血清泛素特异性蛋白酶13(USP13)和组织因子(TF)水平与脓毒症患者预后的相关性。方法选取2020年5月至2022年5月期间我院重症监护病房收治的脓毒症患者96例为研究对象,依据患者入住重症监护病房28 d后的生存情况,将脓毒症患者分为存活组(77例)和死亡组(19例),收集患者一般资料,酶联免疫吸附法(ELISA)检测血清USP13、TF水平,脓毒症患者血清USP13、TF水平与SOFA评分的相关性采用Pearson法分析,USP13、TF对脓毒症患者28 d预后的预测价值采用ROC曲线评估。结果死亡组APACHEⅡ评分、SOFA评分、PCT及TF水平均明显高于存活组,USP13水平明显低于存活组(P<0.05);SOFA评分越高,血清USP13水平越低,TF水平及28 d死亡率越高(P<0.05);血清USP13水平与SOFA评分呈显著负相关(r=-0.513,P<0.05),血清TF水平与SOFA评分呈显著正相关(r=0.487,P<0.05);ROC曲线显示,USP13对预后预测的AUC为0.751,截断值为52.00 pg/ml,其敏感度、特异度分别为94.74%、48.05%;TF对预后预测的AUC为0.770,截断值为70.12 pg/ml,其敏感度、特异度分别为73.68%、71.43%;二者联合对预后预测的AUC为0.849,明显高于二者单独预测(Z联合vs.USP13=2.015、P=0.044;Z联合vs.TF=2.262、P=0.024),其敏感度、特异度分别为73.16%、94.81%。结论USP13、TF在脓毒症不同预后患者血清中差异表达,二者均与脓毒症患者病情密切相关,USP13、TF联合预测脓毒症患者28 d死亡的效能较高。

Objective To explore correlation between serum ubiquitin-specific protease 13(USP13),tissue factor(TF)and prognosis of patients with sepsis.Methods From May 2020 to May 2022,total 96 patients with sepsis admitted to ICU of our hospital were regarded as study subjects.According to survival of patients after 28 days,patients with sepsis were grouped into survival group(n=77)and death group(n=19),general information of patients was collected,serum USP13 and TF were detected by enzyme-linked immunosorbent assay(ELISA),correlation between serum USP13,TF and SOFA scores in patients with sepsis was analyzed by Pearson method,predictive value of USP13 and TF for 28-day prognosis of patients with sepsis was evaluated by ROC curve.Results APACHEⅡscore,SOFA score,PCT and TF in death group were obviously higher than those in survival group,and USP13 was obviously lower than that in survival group(P<0.05).The higher the SOFA score,the lower the serum USP13,the higher the TF and the 28-day mortality rate(P<0.05).Serum USP13 was obviously negatively correlated with SOFA score(r=-0.513,P<0.05),and serum TF was obviously positively correlated with SOFA score(r=0.487,P<0.05).ROC curve showed that the AUC of USP13 for prognosis prediction was 0.751,cut-off value was 52.00 pg/ml,and its sensitivity and specificity were 94.74%and 48.05%,respectively.The AUC of TF for prognosis prediction was 0.770,cut-off value was 70.12 pg/ml,and its sensitivity and specificity were 73.68%and 71.43%,respectively.The AUC of combination of the two to predict the prognosis was 0.849,which was obviously higher than that of the two alone(Z combination vs.USP13=2.015,P=0.044;Z combination vs.TF=2.262,P=0.024),and its sensitivity and specificity were 73.16%and 94.81%,respectively.Conclusion USP13 and TF are differentially expressed in serum of patients with sepsis with different prognosis.Both of them are closely related to condition of patients with sepsis.The combination of USP13 and TF is highly effective in predicting the 28-day death of patients with sepsis.