| 徐盼盼.脓毒症患者血清NAMPT、SIRT1表达与急性肺损伤的相关性研究[J].浙江中西医结合杂志,2022,32(3): |
| 脓毒症患者血清NAMPT、SIRT1表达与急性肺损伤的相关性研究 |
| Study on the correlations between the expressions of serum NAMPT, SIRT1 and acute lung injury in patients with sepsis |
| 投稿时间：2021-05-31 修订日期：2021-07-14 |
| DOI： |
| 中文关键词: 脓毒症 急性肺损伤 烟酰胺磷酸核糖转移酶 沉默信息调节因子1 |
| 英文关键词:sepsis acute lung injury nicotinamide phosphoribosyltransferase silent information regulator 1 |
| 基金项目: |
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| 摘要点击次数: 813 |
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| 中文摘要: |
| 目的：检测脓毒症患者血清烟酰胺磷酸核糖转移酶（NAMPT）、沉默信息调节因子1（SIRT1）水平，并探讨其与脓毒症患者急性肺损伤的关系。方法：选取2017年3月-2021年2月台州市立医院收治的脓毒症患者238例为研究对象，根据是否并发急性肺损伤，分为无急性肺损伤组120例和急性肺损伤组118例。收集患者临床资料，并在患者入院24 h内进行急性生理学与慢性健康状况评分系统Ⅱ（APACHE Ⅱ）评分；肺功能测定仪检测患者肺功能指标第1秒用力呼气容积占预计值百分比（FEV1%）、第1秒用力呼气容积占用力肺活量百分比（FEV1/FVC）、计算呼吸指数（RI）、氧合指数（OI），血气分析仪检测动脉血氧分压（PaO2）、二氧化碳分压（PaCO2）水平；采用酶联免疫吸附法测定患者血清NAMPT、SIRT1水平；采用Pearson相关性分析血清NAMPT、SIRT1水平与APACHE Ⅱ评分、RI、OI、PaCO2、PaO2的相关性；采用二元Logistic回归分析脓毒症患者发生急性肺损伤的影响因素；采用受试者工作特征（ROC）曲线分析血清NAMPT、SIRT1对脓毒症患者发生急性肺损伤诊断价值。结果：与无急性肺损伤组比较，急性肺损伤组患者APACHE Ⅱ评分、PaCO2、RI、血清NAMPT水平显著升高，PaO2、OI、血清SIRT1水平显著降低（P＜0.05）；血清NAMPT水平与APACHE Ⅱ评分、RI、PaCO2水平均呈正相关（P<0.05），与OI、PaO2呈负相关（P<0.05）；血清SIRT1水平与APACHE Ⅱ评分、RI、PaCO2水平均呈负相关（P<0.05），与OI、PaO2呈正相关（P<0.05）；血清NAMPT、SIRT1、APACHE Ⅱ评分是脓毒症患者发生急性肺损伤的独立危险因素（P＜0.05）；血清NAMPT、SIRT1、二者联合检测对脓毒症患者发生急性肺损伤诊断的曲线下面积（AUC）分别为0.771（95%CI：0.710~0.831）、0.835（95%CI：0.779~0.890）、0.908（95%CI：0.869~0.947）。结论：脓毒症急性肺损伤患者血清NAMPT异常高表达、SIRT1异常低表达，二者联合检测可为脓毒症患者临床评估急性肺损伤提供一定参考。 |
| 英文摘要: |
| Objective: To detect the levels of serum nicotinamide phosphoribosyltransferase (NAMPT) and silent information regulator 1 (SIRT1) in patients with sepsis, and to explore the relationship between them and acute lung injury in patients with sepsis. Methods: A total of 238 patients with sepsis admitted to Taizhou Municipal Hospital from March 2017 to February 2021 were selected as the study objects. According to whether complicated with acute lung injury, they were divided into non acute lung injury group 120 cases and acute lung injury group 118 cases. The clinical data of the patients were collected, and the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores were performed within 24 hours after admission; the percentage of forced expiratory volume in the first second to predicted value (FEV1%), percentage of forced expiratory volume in forced vital capacity in the first second (FEV1/FVC) were measured by pulmonary function tester, respiratory index (RI) and oxygenation index (OI) were calculated; arterial partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2) were measured by blood gas analyzer; the serum levels of NAMPT and SIRT1 were measured by enzyme linked immunosorbent assay; pearson correlation analysis was used to analyze the correlation between serum NAMPT, SIRT1 levels and APACHE Ⅱ score, RI, OI, PaCO2, PaO2; binary Logistic regression was used to analyze the influencing factors of acute lung injury in patients with sepsis; and the diagnostic values of serum NAMPT and SIRT1 expressions in sepsis patients with acute lung injury were analyzed by receiver operating characteristic curve (ROC). Results: Compared with non acute lung injury group, APACHE Ⅱ score, PaCO2, RI and serum NAMPT levels were significantly increased, while PaO2, OI and serum SIRT1 levels were significantly decreased in acute lung injury group (P < 0.05); the serum levels of NAMPT were positively correlated with APACHE Ⅱ, RI and PaCO2 (P < 0.05), and negatively correlated with OI and PaO2 (P < 0.05); serum SIRT1 level was negatively correlated with APACHE Ⅱ score, RI and PaCO2 (P < 0.05), and positively correlated with OI and PaO2 (P < 0.05); The serum NAMPT, SIRT1 and APACHE Ⅱ scores were independent risk factors for acute lung injury in sepsis (P < 0.05); The area under the curve (AUC) of serum NAMPT, SIRT1 and their combined detection for the diagnosis of acute lung injury in sepsis patients were 0.771 (95% CI: 0.710~0.831), 0.835 (95% CI: 0.779~0.890), 0.908 (95% CI: 0.869~0.947), respectively. Conclusions: The expression of serum NAMPT in sepsis patients with acute lung injury is abnormally high, and the expression of SIRT1 is abnormally low, the combination of the two can provide some reference for the early clinical evaluation of acute lung injury in patients with sepsis. |
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