血清SGK1、MAPK3、CX3CR1水平对脓毒症并发急性呼吸窘迫综合征的预测及其与预后的关系OA

Objective To explore the predictive value of serum glucocorticoid-regulated kinase 1(SGK1),mitogen-activated protein kinase 3(MAPK3),and C-X3-C motif chemokine receptor 1(CX3CR1)levels for sepsis complicated with acute respiratory distress syndrome(ARDS)and their relationship with patient prognosis.Methods A total of 119 patients with sepsis admitted to the Department of Critical Care Medicine of Xi'an People's Hospital(Xi'an Fourth Hospital)from June 2024 to November 2025 were selected as the case group.They were divided into the concurrent sub-group(n=50)and the non-concurrent sub-group(n=69)based on whether they developed ARDS.According to the survival outcome of sepsis patients within 28 days of hospitalization,they were further divided into the survival sub-group(n=81)and the death sub-group(n=38).Meanwhile,119 healthy individuals who underwent physical examinations at the same hospital during the same period were selected as the healthy control group.The expression levels of serum SGK1,MAPK3,and CX3CR1 were deter-mined by enzyme-linked immunosorbent assay(ELISA).The receiver operating characteristic(ROC)curve was used to ana-lyze the predictive value of serum SGK1,MAPK3,and CX3CR1 for the occurrence of sepsis complicated with ARDS and poor prognosis.The calibration curve was used to verify the consistency between the predicted probability of the model and the actual clinical occurrence probability.Results Compared with the healthy control group,the levels of SGK1,MAPK3 and CX3CRl in the case group increased(t/P=24.570/＜0.001,14.283/＜0.001,19.703/＜0.001).The levels of serum SGK1,MAPK3 and CX3CR1 in the concurrent subgroup were all higher than those in the non-concurrent subgroup(t/P=4.979/＜0.001,3.146/＜0.001,4.698/＜0.001).The levels of serum SGK1,MAPK3 and CX3CR1 in the death subgroup were higher than those in the survival subgroup(t/P=6.482/＜0.001,5.217/＜0.001,6.978/＜0.001).The AUCs of serum SGK1,MAPK3,CX3CR1 and the combination of the three for predicting sepsis complicated with ARDS were 0.864,0.716,0.775 and 0.936,respectively The combination of the three is superior to their individual predictive values(Z/P=2.731/0.006,3.927/0.001,3.159/0.002).The AUCs of serum SGK1,MAPK3,CX3CR1 and the combination of the three for predicting poor prog-nosis in patients with sepsis were 0.788,0.691,0.756 and 0.877,respectively The combination of the three is superior to their individual predictive values(Z/P=2.457/0.008,4.344/＜0.001,3.626/0.001).The calibration curve(solid line)has a high de-gree of conformity with the ideal curve(dashed line),and the probability predicted by the model and the actual probability of occurrence have a very small difference.The prediction accuracy and reliability of the model are relatively strong.Conclusion The levels of serum SGK1,MAPK3,and CX3CR1 are closely related to sepsis complicated with ARDS.The combined de-tection of the three has a high predictive value for sepsis complicated with ARDS,and decreased SGK1 and increased MAPK3 and CX3CR1 levels suggest a poor prognosis for patients.