急性肺水肿患者外周血单个核细胞铁死亡相关基因表达及其与临床预后的关系分析OA
Expressions of Ferroptosis-Related Genes in Peripheral Blood Mononuclear Cells and Their Relationship with Clinical Prognosis of Patients with Acute Pulmonary Edema
目的:探讨急性肺水肿患者外周血单个核细胞(PBMC)中铁死亡相关基因的表达特征,并分析其与患者临床预后的关系.方法:选取 2022 年 3 月至 2025 年 3 月本院收治的 186 例急性肺水肿患者为研究组,另选取同期在本院进行健康体检的 150 例健康人群作为对照组.采用实时荧光定量聚合酶链反应(qRT-PCR)检测研究对象 PBMC 中铁死亡相关基因[谷胱甘肽过氧化物酶 4(GPX4)、溶质载体家族7 成员11(SLC7A11)、长链脂酰辅酶 A 合成酶 4(ACSL4)]的 mRNA 表达情况.随访 6 个月,根据随访期间患者是否发生不良结局(全因死亡、再次因急性肺水肿入院)将其分为预后良好组(n=132)和预后不良组(n=54),比较研究组与对照组以及不同预后患者铁死亡相关基因的表达差异,采用 Cox 风险回归模型分析急性肺水肿患者临床预后的影响因素,并采用受试者工作特征(ROC)曲线分析铁死亡相关基因表达对急性肺水肿患者预后不良的预测价值.结果:研究组 GPX4 mRNA、SLC7A11 mRNA 水平低于对照组,ACSL4 mRNA 水平高于对照组(P<0.05);不同预后患者入院时 APACHE Ⅱ评分、GPX4 mRNA、SLC7A11 mRNA、ACSL4 mRNA 水平差异具有统计学意义(P<0.05),表现为预后良好组入院时 APACHE Ⅱ评分、GPX4 mRNA、SLC7A11 mRNA 水平高于预后不良组,ACSL4 mRNA 水平低于预后不良组.Cox 回归分析结果显示,入院时 APACHE Ⅱ评分升高、GPX4 mRNA 降低、SLC7A11 mR-NA 降低、ACSL4 mRNA 升高均为急性肺水肿患者预后不良的独立危险因素(P<0.05).ROC 结果显示,GPX4 mRNA、SLC7A11 mRNA、ACSL4 mRNA 预测急性肺水肿患者预后不良的曲线下面积(AUC)分别为0.760、0.873、0.710,预测效能均较好.结论:GPX4、SLC7A11、ACSL4 在急性肺水肿患者中异常表达,且其表达水平与患者的预后密切相关.
Objective:To explore the expression characteristics of ferroptosis-related genes in peripheral blood mononuclear cells(PBMC)and analyze their relationship with clinical prognosis of patients with acute pulmonary edema.Methods:A total of 186 patients with acute pulmonary edema and 150 healthy controls in the hospital between March 2022 and March 2025 were enrolled as study group and control group,respective-ly.The mRNA levels of ferroptosis-related genes[glutathione peroxidase 4(GPX4),solute carrier family 7 member 11(SLC7A11),long-chain acyl-CoA synthetase 4(ACSL4)]in PBMC in the two groups were de-tected by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR).According to presence or absence of adverse outcomes(all-cause death,re-admission due to acute pulmonary edema)during 6 months of follow-up,patents in study group were divided into good prognosis group(n=132)and poor prog-nosis group(n=54).The differences in ferroptosis-related genes between study group and control group,as well as among patients with different prognosis were compared.The influencing factors of clinical prognosis in patients with acute pulmonary edema were analyzed by Cox risk regression model,and predictive value of fer-roptosis-related genes in poor prognosis of patients with acute pulmonary edema was analyzed by receiver oper-ating characteristic(ROC)curves.Results:The mRNA levels of GPX4 and SLC7A11 in study group were lower than those in control group,while mRNA level of ACSL4 was higher than that in control group(P<0.05).There were significant differences in APACHE Ⅱ score at admission,mRNA levels of GPX4,SLC7A11 and ACSL4 among patients with different prognosis(P<0.05).APACHE Ⅱ score at admission,mRNA lev-els of GPX4 and SLC7A11 in good prognosis group were higher than those in poor prognosis group,while mR-NA level of ACSL4 was lower than that in poor prognosis group.The results of Cox regression analysis showed that increased APACHE Ⅱ score at admission,decreased GPX4 and SLC7A11 mRNA,and increased ACSL4 mRNA were all independent risk factors of poor prognosis in patients with acute pulmonary edema(P<0.05).The results of ROC curves analysis showed that area under the curve(AUC)values of GPX4,SLC7A11 and ACSL4 mRNA for predicting poor prognosis were 0.760,0.873 and 0.710,all showing good predictive effi-ciency.Conclusion:GPX4,SLC7A11 and ACSL4 are abnormally expressed in patients with acute pulmonary edema,and all the three are closely related to prognosis of patients.
古扎拉依;许姗姗;董辉;热孜万古丽·塔西;郭飞
新疆医科大学第一附属医院,新疆 乌鲁木齐 830054新疆医科大学第一附属医院,新疆 乌鲁木齐 830054新疆医科大学第一附属医院,新疆 乌鲁木齐 830054新疆医科大学第一附属医院,新疆 乌鲁木齐 830054新疆医科大学第一附属医院,新疆 乌鲁木齐 830054
急性肺水肿铁死亡相关基因溶质载体家族7成员11谷胱甘肽过氧化物酶4长链脂酰辅酶A合成酶4
Acute pulmonary edemaFerroptosis-related geneSolute carrier family 7 member 11Glutathione peroxidase 4Long-chain acyl-CoA synthetase 4
《河北医学》 2026 (6)
1017-1022,6
省部共建中亚高发病成因与防治国家重点实验室高原病专项(SKL-HIDCA-2024-GY5)
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