血清sNRP-1、NINJ1与脓毒症患者病情程度的关系及对预后的预测效能OA

Objective To investigate the relationship of serum soluble neuropilin-1(sNRP-1)and nerve injury-induced protein 1(NINJ1)levels with disease severity of patients with sepsis and their predictive efficacy for prognosis.Methods A total of 265 sepsis patients(sepsis group)admitted to the Department of Critical Care Medicine of Changshu First People's Hospital from January 2021 to May 2024,and 135 healthy volunteers(control group)who received health examination at the same hospital during the same period were enrolled.Sepsis patients were further divided into a general sepsis group(n=128)and a septic shock group(n=137)based on disease severity,and they were divided into a death group(n=81)and a survival group(n=184)according to 90-day prognosis.Clinical data of patients were collected,and serum sNRP-1 and NINJ1 levels were measured by enzyme-linked immunosorbent assay.Spearman rank correlation was used to analyze the correlation of serum sNRP-1 and NINJ1 levels with Sequential Organ Failure Assessment(SOFA)score and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score in sepsis patients.Multivariate logistic regression analysis was performed to identify factors influencing mortality of sepsis patients.Receiver operating characteristic(ROC)curve analysis was used to evaluate the efficacy of serum sNRP-1 and NINJ1 levels in predicting mortality of sepsis patients.Results Compared with the control group,serum sNRP-1 and NINJ1 levels were significantly higher in the sepsis group(both P＜0.01).Compared with the general sepsis group,serum sNRP-1 and NINJ1 levels were also significantly higher in the septic shock group(both P＜0.01).Spearman rank correlation analysis showed that serum sNRP-1 and NINJ1 levels were positively correlated with SOFA score(rs=0.735,0.757,respectively,both P＜0.001)and APACHE Ⅱ score(rs=0.716,0.752,respectively,both P＜0.001).The 90-day mortality rate of the 265 sepsis patients was 30.57％(81/265).Compared with the survival group,serum sNRP-1 and NINJ1 levels were significantly higher in the death group(both P＜0.05).Multivariate logistic regression analysis showed that high levels of sNRP-1 and NINJ1 were independent risk factors for mortality in sepsis patients(both P＜0.05).ROC curve analysis showed that the area under the curve(AUC)for serum sNRP-1 and NINJ1 alone,and their combination in predicting mortality of sepsis patients were 0.791,0.813,and 0.890,respectively,with the combined prediction efficacy being significantly higher than that of either marker alone(both P＜0.05).Conclusion Elevated serum levels of sNRP-1 and NINJ1 in sepsis patients are associated with disease severity and increased risk of mortality,suggesting their potential as biomarkers for disease assessment and prognosis prediction in sepsis patients.