跨膜蛋白176B、白细胞介素-1β、白细胞介素-6及序贯器官衰竭评估评分对脓毒症及脓毒性休克患者早期预后的预测价值OA

Objective To investigate the predictive value of transmembrane protein 176B(TMEM176B)mRNA,interleukin-1 β(IL-1 β),interleukin-6(IL-6)levels in peripheral blood mononuclear cells(PBMCs),and the sequential organ failure assessment(SOFA)score for the 28-day prognosis of patients with sepsis and septic shock.Methods A total of 159 patients with sepsis and septic shock were retrospectively enrolled and divided into survival group(n=101)and non-survival group(n=58)based on their 28-day survival status.Clinical data were collected.TMEM176B mRNA expression in PBMCs was detected by real-time fluorescent quantitative polymerase chain reaction,while IL-1 β and IL-6 levels were measured by enzyme-linked immunosorbent assay.The SOFA score was also evaluated.Pearson correlation analysis was used to explore the correlations of the SOFA score with TMEM176B mRNA,IL-1 β,and IL-6 levels.Univariate and multivariate logistic regres-sion analyses were performed to identify factors influencing 28-day mortality.Receiver operating characteristic(ROC)curves were plotted to assess the predictive efficacy of TMEM176B mRNA,IL-1β,IL-6,and the SOFA score for 28-day mortality.Results The TMEM176B mRNA expres-sion level was significantly lower in the non-survival group than in the survival group,whereas IL-1 βand IL-6 levels and the SOFA score were significantly higher(all P＜0.05).Pearson correlation analysis revealed positive correlations of the SOFA score with IL-1 β(r=0.469,P=0.010)and IL-6(r=0.523,P=0.003)levels,and a negative correlation with TMEM176B mRNA level(r=-0.617,P＜0.001).Multivariate logistic regression analysis demonstrated that TMEM176B mRNA＜1.14,IL-1β≥2.39 pg/mL,IL-6＞26.13 pg/mL,and a SOFA score＞13.10 were independent risk factors for 28-day mortality in patients with sepsis and septic shock(P＜0.05).ROC curve a-nalysis showed that the area under the curve(AUC)for the combined prediction of 28-day mortality using peripheral blood TMEM176B mRNA,IL-1β,IL-6,and the SOFA score was 0.927,which was significantly higher than the AUC values for each individual marker(0.892,0.739,0.710 and 0.777,respectively;P＜0.001).Conclusion In patients with sepsis and septic shock,TMEM176B mRNA expression in PBMCs is significantly decreased,while IL-1 β and IL-6 levels and the SOFA score are significantly increased.The combined application of these four markers demonstrates high predictive efficacy for 28-day mortality and provides a reference for the early clinical identification of high-risk patients.