连续性血液净化治疗脓毒症患者血清STIM1、sP-selectin水平变化及与预后的关系

Changes in serum STIM1 and sP-selectin levels in sepsis patients treated with continuous blood purification and their relationship with prognosis

目的探究连续性血液净化(CBP)治疗脓毒症患者血清基质相互作用分子1(STIM1)、可溶性P选择素(sP-selectin)水平变化及与预后的关系。方法收集我院2021年6月—2023年6月收治的150例CBP治疗的脓毒症患者作为观察对象(CBP组),根据28 d预后情况,将患者分为预后良好组113例和预后不良组37例,同时选取在我院健康门诊体检的健康者136例作为对照组,采用酶联免疫吸附试验(ELISA)法测定血清中STIM1、sP-selectin水平,多因素Logistic回归分析CBP治疗脓毒症患者预后不良发生的影响因素,受试者工作特征(ROC)曲线分析血清STIM1、sP-selectin水平对CBP治疗脓毒症患者预后不良的预测价值。结果与对照组比较,CBP组血清STIM1、sP-selectin水平显著升高(P<0.05);预后不良组CBP时间、活化部分凝血酶原时间(APTT)、C反应蛋白(CRP)、STIM1、sP-selectin水平显著高于预后良好组(P<0.05);APTT、STIM1、sP-selectin是影响CBP治疗脓毒症患者预后不良发生的独立危险因素(P<0.05);STIM1、sP-selectin水平和二者联合预测发生预后不良的曲线下面积(AUC)分别为0.795、0.761、0.886,二者联合预测价值优于单独预测(Z=2.169、2.881;P=0.030、0.004)。结论脓毒症患者血清中STIM1、sP-selectin水平升高,与患者CBP治疗预后不良发生有关,可作为CBP治疗脓毒症患者病情和预后评估的标志物。

Objective To investigate the changes in serum stromal interaction molecule 1(STIM1)and soluble Pselectin(sP-selectin)levels in sepsis patients treated with continuous blood purification(CBP)and their relationship with prognosis.Methods A total of 150 sepsis patients treated with CBP from June 2021 to June 2023 in our hospital were regarded as observation subjects(CBP group).Based on the 28 day prognosis,the patients were divided into a good prognosis group of 113 cases and a poor prognosis group of 37 cases,meantime,136 healthy individuals who underwent physical examinations at our hospital's health clinic were selected as the control group.The levels of STIM1 and sP-selectin in serum were measured using enzyme-linked immunosorbent assay(ELISA),multivariate Logistic regression was applied to analyze the influencing factors of poor prognosis in sepsis patients treated with CBP,receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum STIM1 and sP-selectin levels for poor prognosis in sepsis patients treated with CBP.Results Compared with the control group,the serum levels of STIM1 and sP-selectin in the CBP group were obviously increased(P<0.05);the CBP time,APTT,CRP,STIM1,and sP-selectin levels in the poor prognosis group were obviously higher than those in the good prognosis group(P<0.05);APTT,STIM1,and sP-selectin were independent risk factors for poor prognosis in sepsis patients treated with CBP(P<0.05);the area under the curve(AUC)of STIM1,sP-selectin levels,and their combined prediction for poor prognosis was 0.795,0.761,and 0.886,respectively,the combined prediction value of the two was better than that of single prediction(Z=2.169,2.881;P=0.030,0.004).Conclusion The levels of STIM1 and sP-selectin in the serum of sepsis patients elevate,they are associated with poor prognosis after CBP treatment,and may serve as markers for evaluating the condition and prognosis of sepsis patients treated with CBP.