血清USP10和SIRT6水平与急性肺损伤患者预后的关系研究

Relationship between serum USP10 and SIRT6 levels and prognosis of patients with acute lung injury

目的探讨血清泛素特异性蛋白酶10(USP10)和沉默调节蛋白6(SIRT6)水平与急性肺损伤(ALI)患者预后的关系。方法前瞻性选取2023年1月至2023年11月就诊于康复大学青岛中心医院(青岛市中心医院)重症医学科确诊筛选的ALI患者78例为研究对象,设为ALI组;另外选取同期在同医院体检中心体检肺功能正常的患者70例设为对照组。实时荧光定量PCR检测两组研究对象血清中USP10 mRNA相对表达量,采用酶联免疫吸附试验检测血清SIRT6表达水平。比较两组研究对象以及不同病情ALI患者的血清中USP10 mRNA和SIRT6的表达水平;采用多因素Logistic回归分析ALI患者预后危险因素;采用Pearson相关性分析USP10 mRNA与SIRT6表达的相关性;采用受试者工作特征(ROC)曲线分析USP10 mRNA和SIRT6预测ALI患者预后的价值。结果ALI组患者血清USP10 mRNA和SIRT6的表达水平明显低于对照组,差异均有统计学意义(P<0.05)。重度患者血清USP10 mRNA和SIRT6的表达水平明显低于中度患者,中度患者血清中USP10 mRNA和SIRT6表达水平明显低于轻度患者,差异均有统计学意义(P<0.05)。死亡患者血清中USP10 mRNA和SIRT6表达水平明显低于存活患者,差异均有统计学意义(P<0.05)。USP10 mRNA和SIRT6低表达为ALI患者预后的独立危险因素(P<0.05)。USP10 mRNA与SIRT6表达呈正相关性(r=0.373,P<0.05);USP10 mRNA最佳截断值为0.69,预测ALI患者预后的曲线下面积(AUC)为0.805,95%CI:0.738~0.871,敏感度为78.21%,特异度为67.43%;SIRT6最佳截断值为18.69 ng/mL,预测ALI患者预后的AUC为0.871,95%CI:0.817~0.925,敏感度为84.62%,特异度为73.08%;USP10 mRNA与SIRT6联合检测预测ALI患者预后的AUC为0.930,95%CI:0.894~0.967,敏感度为93.59%,特异度为76.92%,优于两者单独检测。结论ALI患者血清中USP10和SIRT6明显降低,与ALI的不良预后密切相关,联合测定血清中USP10和SIRT6可能提升对ALI患者预后的预测价值。

Objective To investigate the relationship between serum ubiquitin specific protease 10(USP10)and silence-regulatory protein 6(SIRT6)levels and prognosis of patients with acute lung injury(ALI).Methods Seventy-eight ALI patients diagnosed and screened in the Department of Intensive Care Medicine,Qingdao Central Hospital of Rehabilitation University(Qingdao Central Hospital)from January 2023 to November 2023 were prospectively selected as the study objects and were selected as the ALI group.In addition,70 patients with normal lung function in the physical examination center of the same hospital were selected as the control group.The relative expression of serum USP10 mRNA in the two groups was detected by Real-time fluorescence quantitative PCR,the expression level of serum SIRT6 was detected by enzyme-linked immunosorptive assay.The expression levels of serum USP10 mRNA and SIRT6 in the two groups of study subjects and ALI patients with different conditions were compared;and the prognostic risk factors of ALI patients were analyzed by multivariate Logistic regression;the correlation between USP10 mRNA and SIRT6 expression was analyzed by Pearson correlation,and the prognostic value of USP10 mRNA and SIRT6 in ALI patients was analyzed by receiver operating characteristic(ROC)curve.Results The expression levels of serum USP10 mRNA and SIRT6 in the ALI group were significantly lower than those of the control group,the differences were statistically significant(P<0.05).Serum heavy USP10 mRNA and SIRT6 expression levels in severe patients were significantly lower than those in moderate patients,and serum heavy USP10 mRNA and SIRT6 expression levels in moderate patients were significantly lower than those in mild patients,the differences were statistically significant(P<0.05).The expression levels of USP10 mRNA and SIRT6 in serum were significantly lower in dead patients than in surviving patients,the differences were statistically significant(P<0.05).Low expression of USP10 mRNA and SIRT6 were independent risk factors for the prognosis of ALI patients(P<0.05).USP10 mRNA and SIRT6 expression were positively correlated(r=0.373,P<0.05).The optimal cut-off value of USP10 mRNA was 0.69,the area under the curve(AUC)for predicting the prognosis of ALI patients was 0.805,95%CI:0.738-0.871,sensitivity was 78.21%,specificity was 67.43%.The optimal cut-off value of SIRT6 was 18.69 ng/mL,and the AUC for predicting the prognosis of ALI patients was 0.871,95%CI:0.817-0.925,sensitivity was 84.62%,and specificity was 73.08%.The combined detection of USP10 mRNA and SIRT6 predicted the prognosis of ALI patients with AUC was 0.930,95%CI:0.894-0.967,sensitivity was 93.59%,specificity was 76.92%,which was better than the two detection alone.Conclusion Serum USP10 and SIRT6 are significantly decreased in ALI patients,which is closely related to the poor prognosis of ALI.The combined determination of serum USP10 and SIRT6 may improve the prognostic value of ALI patients.