脓毒症患者sNRP-1水平及其与器官损伤和预后的相关性OA
Levels of sNRP-1 in Patients with Sepsis and its Correlation with Organ Damage and Prognosis
目的 分析脓毒症患者可溶性神经纤毛蛋白-1(sNRP-1)水平及其与器官损伤和预后的相关性.方法 前瞻性选取2021年1月至2023年8月于我院进行治疗的94例脓毒症患者为研究对象进行随访,截止随访1年,最终89例获得随访,根据预后情况分为存活组(n=59)和死亡组(n=30).收集患者的临床资料,应用Pearson相关分析脓毒症患者sNRP-1水平与器官损伤的相关性,并应用多因素Logistic分析脓毒症患者预后的影响因素;采用限制性立方样条(RCS)模型分析sNRP-1水平与脓毒症患者预后的剂量-反应关系.结果 截至随访结束,94例患者中5例失访,其中有59例(66.29％)患者存活,30例(33.71％)患者死亡.两组患者急性生理与慢性健康评分(APACHE Ⅱ)、序贯器官衰竭估计评分(SOFA)、sNRP-1、C反应蛋白、降钙素原、N末端前脑钠肽前体(NT-proBNP)、肌酐、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)比较,差异有统计学意义(t=-1.998、-9.529、-7.006、-2.001、-2.002、-2.465、-2.506、-5.137、-3.134,P＜0.05).Pearson 直线相关分析显示,肌酐(r=0.326,P=0.002)、ALT(r=0.334,P=0.001)、AST(r=0.341,P=0.001)、NT-proBNP(r=0.339,P=0.001)与 sNRP-1 水平水平均呈正相关.多因素 Logistic 分析显示,SO-FA评分(OR=2.516,P=0.001)、sNRP-1(OR=116.846,P=0.003)为影响脓毒症患者预后的独立危险因素.RCS分析显示,sNRP-1水平与脓毒症患者预后呈现线性剂量-反应关系(P非线性=0.243,P整体=0.002).结论 sNRP-1为脓毒症患者预后的独立影响因素,且sNRP-1水平与脓毒症患者预后存在线性剂量-反应关系.
Objective To analyze levels of soluble neuropilin-1(sNRP-1)in patients with sepsis and its correlation with organ injury and prognosis.Methods From January 2021 to August 2023,94 patients with sepsis who were treated in our hospital were prospectively enrolled and followed up for 1 year.Up to 1 year of follow-up,89 patients were finally followed up and divided into survival group(n=59)and death group(n=30)according to prognosis.Clinical data of patients were collected,the correla-tion between sNRP-1 level and organ damage in sepsis patients was analyzed by Pearson correlation,and the prognostic factors of sepsis patients were analyzed by multivariate Logistic analysis.Restricted cubic spline(RCS)model was used to analyze the dose-response relationship between sNRP-1 level and prognosis of sepsis patients.Results Up to the end of follow-up,5 cases of 94 patients were lost to follow-up,of which 59 patients(66.29％)with sepsis were classified as the survival group and 30 patients(33.71％)died as the death group.There were statistically significant differences in APACHE Ⅱ score,SOFA score,sNRP-1,C-reactive protein,procalcitonin,NT-proBNP,creatinine,alanine aminotransferase and aspartate aminotransferase between two groups(t=-1.998,-9.529,-7.006,-2.001,-2.002,-2.465,-2.506,-5.137,-3.134,P＜0.05).Pearson linear correlation analysis showed that creatinine(r=0.326,P=0.002),alanine aminotransferase(r=0.334,P=0.001),aspartate aminotransferase(r=0.341,P=0.001),NT-proBNP(r=0.339,P=0.001)were positively correlated with sNRP-1 levels.Mul-tivariate Logistic analysis showed that SOFA score(OR=2.516,P=0.001),sNRP-1(OR=116.846,P=0.003)were independ-ent risk factors for the prognosis of sepsis patients.RCS analysis showed a linear dose-response relationship between sNRP-1 levels and the prognosis of sepsis patients(Pnonlinear=0.243,Pglobal=0.002).Conclusion sNRP-1 would be an independent prognostic factor in sepsis patients,and there would be a linear dose-response relationship between sNRP-1 level and prognosis in sepsis pa-tients.
屈乐;杨柳;罗建江
新疆医科大学第四附属医院呼吸与感染性疾病科,呼吸四科,新疆乌鲁木齐 830000新疆医科大学第四附属医院呼吸与感染性疾病科,呼吸四科,新疆乌鲁木齐 830000新疆医科大学第四附属医院呼吸与感染性疾病科,呼吸四科,新疆乌鲁木齐 830000
医药卫生
脓毒症可溶性神经纤毛蛋白-1器官损伤预后
sepsissoluble neuropilin-1organ damageprognosis
《四川医学》 2026 (5)
481-486,6
省部共建中亚高发病成因与防治国家重点实验室开放课题资助项目(编号:SKL-HIDCA-2022)
评论