血清SIRT6、DR5、KL-6水平与重症肺炎并发ARDS患者病情及预后的关系OA

Objective To investigate the relationship between serum silent information regulator 6(SIRT6),death receptor 5(DR5),Krebs von den lungen-6(KL-6)levels and the condition and prognosis of patients with severe pneumonia complicated with acute respiratory distress syndrome(ARDS).Methods A total of 100 patients with severe pneumonia complicated by ARDS who were treated in the hospital were se-lected as the ARDS group,100 patients with severe pneumonia as the pneumonia group,and 100 healthy indi-viduals who underwent physical examinations in the hospital during the same period as the healthy group.The severity of patients with severe pneumonia complicated by ARDS was evaluated by the oxygenation index,and they were divided into the mild-degree group,the moderate-degree group and the severe-degree group.Based on the 28-day follow-up results,the patients with severe pneumonia complicated by ARDS were divided into the survival group and the death group.The serum levels of SIRT6,DR5 and KL-6 in each group were detec-ted by enzyme-linked immunosorbent assay.Spearman correlation analysis was used to analyze the correlation between the serum levels of SIRT6,DR5 and KL-6 and the severity of ARDS.Multivariate Logistic regression analysis was used to analyze the influencing factors for death in patients with severe pneumonia complicated by ARDS.The receiver operating characteristic(ROC)curve was plotted to evaluate the predictive value of serum SIRT6,DR5 and KL-6 for death in patients with severe pneumonia complicated by ARDS.Results The serum SIRT6 level in the pneumonia group and the ARDS group was lower than that in the healthy group,while the serum DR5 and KL-6 levels were higher than those in the healthy group,and the differences were all statistically significant(P<0.05).The serum SIRT6 level in the ARDS group was lower than that in the pneumonia group,and the serum DR5 and KL-6 levels were higher than those in the pneumonia group,with statistically significant differences(P<0.05).The results of oxygenation index evaluation showed that among the 100 patients in the ARDS group,there were 24 cases in the mild-degree group,30 cases in the moderate-de-gree group,and 46 cases in the severe-degree group.The serum SIRT6 levels in the moderate-degree group and severe-degree group were lower than that in the mild-degree group,and the DR5 and KL-6 levels were higher than those in the mild-degree group,with statistically significant differences(P<0.05).The serum SIRT6 level in the severe-degree group was lower than that in the moderate-degree group,and the DR5 and KL-6 lev-els were higher than those in the moderate-degree group,with statistically significant differences(P<0.05).The results of Spearman correlation analysis showed that the serum SIRT6 level in patients with severe pneu-monia complicated by ARDS was negatively correlated with the severity of ARDS(rs=-0.782,P<0.001),while the serum DR5 and KL-6 levels were positively correlated with the severity of ARDS(rs=0.653,0.610,both P<0.001).The 28-day follow-up results showed that 63 patients with severe pneumonia compli-cated by ARDS were included in the survival group,and 37 were included in the death group.The serum SIRT6 level in the death group was lower than that in the survival group,and the serum DR5 and KL-6 levels were higher than those in the survival group,with statistically significant differences(P<0.05).The results of multivariate Logistic regression analysis showed that increased serum SIRT6 level was a protective factor for death in patients with severe pneumonia complicated by ARDS(P<0.05),while increased serum DR5 and KL-6 levels were risk factors for death in patients with severe pneumonia complicated by ARDS(P<0.05).The results of ROC curve analysis showed that the area under the curve of the combined prediction of death in patients with severe pneumonia complicated by ARDS by serum SIRT6,DR5 and KL-6 was larger than that of each indicator alone(P<0.05).Conclusion In patients with severe pneumonia complicated by ARDS,the se-rum SIRT6 level is low,while the serum DR5 and KL-6 levels are high,and the serum levels of SIRT6,DR5 and KL-6 are related to the aggravation of ARDS and an increased risk of patient death.The combined predic-tion of death in patients with severe pneumonia complicated by ARDS by serum SIRT6,DR5 and KL-6 has a high value.