脓毒症所致的ALI/ARDS患者血浆SIRT-1、syndecan-1的表达水平及其对预后的影响

doi:10.11958/20221108

摘要/Abstract

摘要： Objective To analyze plasma expression levels of silent information regulation 1 (SIRT-1) and syndecan-1 in patients with acute lung injury (ALI)/ associated acute respiratory distress syndrome (ARDS) and their correlation with prognosis. Methods A total of 106 patients with ALI/ARDS were selected as the ALI/ARDS group. The survival status of all patients within one month after admission was counted, and they were divided into the survival group (66 cases) and the death group (40 cases) according to their survival status. In addition, 50 healthy volunteers were selected as the control group. Expression levels of plasma SIRT-1 and syndecan-1 of all subjects were detected by enzyme-linked immunosorbent assay. Clinical data of acute physiology and chronic health score Ⅱ (APACHE Ⅱ) and lung injury score (LIS) were collected. Results The plasma SIRT-1 level was lower in the ALI/ARDS group than that in the control group, and the plasma syndecan-1 level was higher than that in the control group (P<0.05). The plasma SIRT-1 level was lower in the death group than that in the surviva group, and APACHE Ⅱ score, LIS score and plasma syndecan-1 level were significantly higher than those in the survival group (P<0.05). The plasma level of SIRT-1 in patients with ALI/ARDS was negatively correlated with syndecan-1, APACHE Ⅱ score and LIS score, the plasma level of syndecan-1 was positively correlated with APACHEⅡ score and LIS score (P<0.05). Higher APACHEⅡ score, LIS score and plasma syndecan-1 were the risk factors of death in patients with ALI/ARDS, while higher plasma SIRT-1 was the protective factor of death in patients with ALI/ARDS (P<0.05). Values of plasma SIRT-1 and syndecan-1 in evaluating the prognosis of patients with ALI/ARDS were high, and the areas under the curve were 0.860 (95%CI: 0.791-0.930) and 0.870 (95%CI: 0.800-0.940) respectively. Conclusion The plasma SIRT-1 level is abnormally low and syndecan-1 level is abnormally high in patients with ALI/ARDS. The expression levels of SIRT-1 and syndecan-1 are closely related to the prognosis of patients.

关键词: 急性肺损伤, 呼吸窘迫综合征, 多配体蛋白聚糖1, 预后, 沉默信息调节因子1

Key words: acute lung injury, respiratory distress syndrome, syndecan-1, prognosis, silent information regulator 1

中图分类号:

R563.8

图/表 5

参考文献 21

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组别	n	SIRT-1	syndecan-1
对照组	50	1.42±0.36	211.24±57.26
ALI/ARDS组	106	0.81±0.27	501.67±81.32
t		11.790^＊＊	22.719^＊＊

组别	n	SIRT-1	syndecan-1
对照组	50	1.42±0.36	211.24±57.26
ALI/ARDS组	106	0.81±0.27	501.67±81.32
t		11.790^＊＊	22.719^＊＊

组别	n	男性	年龄（岁）	BMI （kg/m²）	原发疾病				APACHEⅡ （分）	LIS （分）	SIRT-1 （μg/L）	syndecan-1 （μg/L）
组别	n	男性	年龄（岁）	BMI （kg/m²）	呼吸道感染	尿路感染	腹腔感染	其他	APACHEⅡ （分）	LIS （分）	SIRT-1 （μg/L）	syndecan-1 （μg/L）
生存组	66	36（54.55）	56.71±9.42	22.25±2.31	30（45.45）	14（21.21）	12（18.18）	10（15.15）	19.89±6.42	1.98±0.22	0.96±0.27	451.19±72.35
死亡组	40	25（62.50）	58.04±9.89	22.01±2.08	22（55.00）	8（20.00）	7（17.50）	3（7.50）	28.43±9.33	2.28±0.25	0.56±0.22	584.97±90.31
t		0.645	0.691	0.538	1.676				5.570^＊＊	6.246^＊＊	7.909^＊＊	8.391^＊＊

组别	n	男性	年龄（岁）	BMI （kg/m²）	原发疾病				APACHEⅡ （分）	LIS （分）	SIRT-1 （μg/L）	syndecan-1 （μg/L）
组别	n	男性	年龄（岁）	BMI （kg/m²）	呼吸道感染	尿路感染	腹腔感染	其他	APACHEⅡ （分）	LIS （分）	SIRT-1 （μg/L）	syndecan-1 （μg/L）
生存组	66	36（54.55）	56.71±9.42	22.25±2.31	30（45.45）	14（21.21）	12（18.18）	10（15.15）	19.89±6.42	1.98±0.22	0.96±0.27	451.19±72.35
死亡组	40	25（62.50）	58.04±9.89	22.01±2.08	22（55.00）	8（20.00）	7（17.50）	3（7.50）	28.43±9.33	2.28±0.25	0.56±0.22	584.97±90.31
t		0.645	0.691	0.538	1.676				5.570^＊＊	6.246^＊＊	7.909^＊＊	8.391^＊＊

变量	β	SE	Wald χ²	P	OR（95%CI）
APACHEⅡ	0.542	0.245	4.894	0.027	1.719（1.064~2.779）
LIS	0.767	0.284	7.294	0.007	2.153（1.234~3.757）
SIRT-1	-0.271	0.118	5.274	0.022	0.763（0.605~0.961）
syndecan-1	0.891	0.321	7.705	0.006	2.438（1.299~4.573）
常数项	0.357	0.174	4.210	0.040	1.429