血清程序性死亡蛋白1和高迁移率族蛋白1水平与脓毒症并发肝损伤的相关性研究

Study on correlation of serum PD1 and HMGB1 with liver injury in patients with sepsis

目的探讨血清程序性死亡蛋白1(programmed cell death protein 1,PD1)、高迁移率族蛋白1(high mobility group protein 1,HMGB1)水平与脓毒症并发肝损伤的相关性。方法选取58例脓毒症并发肝损伤患者作为肝损伤组,同期选择58例单纯脓毒症患者作为对照组。根据肝损伤程度将肝损伤组患者分为轻度损伤组(n=18)、中度损伤组(n=26)、重度损伤组(n=14);比较患者血清PD1、HMGB1表达水平;采用Spearman秩相关分析患者血清PD1、HMGB1表达水平与肝损伤程度的相关性;采用受试者工作特征曲线(receiver operating characteristic,ROC)评估血清PD1、HMGB1表达水平对脓毒症患者并发肝损伤的诊断价值。结果肝损伤组患者的血清PD1、HMGB1表达水平均高于对照组(P<0.05);轻度损伤组、中度损伤组、重度损伤组患者的血清PD1、HMGB1表达水平依次递增(P<0.05);Spearman秩相关分析显示:脓毒症患者血清PD1、HMGB1表达水平与肝损伤程度呈正相关(P<0.05);ROC曲线结果显示,血清PD1、HMGB1表达水平对脓毒症并发肝损伤的曲线下面积(area under the curve,AUC)值分别为0.718和0.777,且两者联合检测的AUC值最大,为0.865。结论血清PD1、HMGB1表达水平与脓毒症并发肝损伤密切相关,且两者联合检测对脓毒症患者并发肝损伤的诊断价值最高。

Objective To study the correlation of serum programmed cell death protein 1(PD1)and high mobility group protein 1(HMGB1)with liver injury in patients with sepsis.Methods Fifty-eight patients with sepsis and liver injury were selected as liver injury group,and another 58 sepsis patients were concurrently enrolled as control group.Live injury group was further classified into mild injury group(n=18),moderate injury group(n=26),and severe injury group(n=14)according to the severity of liver injury.Serum PD1 and HMGB1 expression levels were compared between the two groups.Spearman correlation analysis was conducted to explore the correlation of serum PD1 and HMGB1 with liver injury in patients with sepsis,and receiver operating characteristic(ROC)curve was plotted to evaluate the diagnostic value of serum PD1 and HMGB1 for liver injury in patients with sepsis.Results Serum PD1 and HMGB1 expression levels of live injury group were higher than those of control group(P<0.05).With the aggravation of liver injury,there was a gradual increase in serum PD1 and HMGB1 levels(P<0.05).Spearman correlation analysis denoted that the expression levels of serum PD1 and HMGB1 in patients with sepsis were positively correlated with the severity degree of liver injury(P<0.05).ROC curve analysis revealed that the area under the curve(AUC)of separate test of serum PD1 and HMGB1 for the diagnosis of liver injury in sepsis was 0.718 and 0.777 respectively,which was smaller than AUC of combined test of the two,reaching 0.865.Conclusion Expression levels of serum PD1 and HMGB1 are closely related to the development of liver injury in patients with sepsis,and the combined test of the two is of great highest diagnostic value for liver injury in sepsis patients.