[1]阮本良,邵 敏,韩晓洁.脓毒症继发急性肺损伤患者血清CCL25和PARK7表达水平及其临床价值研究[J].现代检验医学杂志,2024,39(01):90-94+117.[doi:10.3969/j.issn.1671-7414.2024.01.016]
　RUAN Benliang,SHAO Min,HAN Xiaojie.Study on the Expression Levels and Clinical Value of Serum CCL25 and PARK7 in Patients with Acute Lung Injury Secondary to Sepsis[J].Journal of Modern Laboratory Medicine,2024,39(01):90-94+117.[doi:10.3969/j.issn.1671-7414.2024.01.016]
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脓毒症继发急性肺损伤患者血清CCL25和PARK7表达水平及其临床价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年01期
页码:
90-94+117
栏目:
论著
出版日期:
2024-01-15

文章信息/Info

Title:
Study on the Expression Levels and Clinical Value of Serum CCL25 and PARK7 in Patients with Acute Lung Injury Secondary to Sepsis
文章编号:
1671-7414（2024）01-090-06
作者:
阮本良1; 邵 敏2; 韩晓洁1
（1. 合肥京东方医院重症医学科，合肥 230013；2. 安徽医科大学第一附属医院重症医学科，合肥 230022）
Author(s):
RUAN Benliang1;  SHAO Min2;  HAN Xiaojie1
（1. Department of Critical Care Medicine, Hefei Jingdongfang Hospital, Hefei 230013, China; 2. Department of Critical Care Medicine, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China）
关键词:
脓毒症; 急性肺损伤; C-C 模体趋化因子配体25; 人帕金森蛋白7
分类号:
R631；R392.11
DOI:
10.3969/j.issn.1671-7414.2024.01.016
文献标志码:
A
摘要:
目的　探讨脓毒症患者血清C-C 模体趋化因子配体25(C-C motif chemokine ligand 25，CCL25)，人帕金森病蛋白7(Parkinson’s disease protein 7，PARK7) 水平与急性肺损伤(acute lung injury，ALI) 的关系及临床意义。方法　选取2019 年2 月～ 2023 年2 月合肥京东方医院诊治的138 例脓毒症患者为脓毒症组，根据是否继发ALI 分为ALI 组(n=40)和非ALI 组(n=98)，以同期体检的70 例健康人为对照。酶联免疫吸附法（enzyme linked immunosorbent assay，ELISA）检测血清CCL25 和PARK7 水平。Pearson 相关分析血清CCL25，PARK7 与临床指标的相关性。多因素Logistic 回归分析脓毒症继发ALI 的危险因素。受试者工作特征曲线分析血清CCL25 和PARK7 水平对脓毒症继发ALI 的预测价值。结果　脓毒症组患者血清CCL25（367.52±46.87ng/L），PARK7(54.26±17.45μg/L）水平高于对照组（48.17±5.26ng/L，12.31±4.12μg/L），差异具有统计学意义(t=46.825，19.813，均P ＜ 0.05)。ALI 组患者血清CCL25（434.65±52.87ng/Lvs 340.12±42.64ng/L），PARK7(103.47±22.51μg/L vs 34.18±7.46μg/L），呼吸指数（1.58±0.48 vs 0.88±0.07）、动脉血二氧化碳分压（PaCO2）（50.11±6.27mmHg vs 40.42±5.20mmHg）、急性生理学与慢性健康状况评价Ⅱ（APACHE Ⅱ）评分（23.37±3.82 分 vs 17.15±3.41 分）、序贯器官衰竭（SOFA）评分（13.56±2.93 分 vs 10.18±2.81 分）均高于非ALI 组，而氧合指数（237.14±23.56 分 vs 341.14±21.37 分）、动脉血氧分压（PaO2）（55.87±8.03mmHg vs 63.11±7.14mmHg）低于非ALI 组，差异具有统计学意义(t=10.998，27.151，14.145，9.342，9.385，6.332，25.172，5.210，均P<0.05)。ALI 组患者血清CCL25，PARK7 水平与APACHE Ⅱ评分、SOFA 评分、呼吸指数、PaCO2 呈正相关(r=0.579 ～ 0.801，均P<0.05)，与氧合指数、PaO2 呈负相关(r=-0.687，-0.643；-0.654，-0.712，均P<0.05)。血清CCL25（OR=1.309，95%CI：1.040 ～ 1.646），PARK7（OR=1.288，95%CI：1.016 ～ 1.633），APACHE Ⅱ评分（OR=1.188，95%CI：1.019 ～ 1.384），SOFA 评分（OR=1.197，95%CI：1.006 ～ 1.425）是影响脓毒症患者继发ALI 的独立危险因素。血清CCL25，PARK7联合对脓毒症继发ALI 预测的曲线下面积（95%CI)[0.833(0.784 ～ 0.872)] 大于单项指标[0.770(0.725 ～ 0.835)，0.741(0.691 ～ 0.790)]，差异具有统计学意义（Z=4.602，4.318，均P<0.05）。结论　脓毒症患者血清CCL25 和PARK7 水平升高，是影响脓毒症继发ALI 发生的独立危险因素，两者联合对脓毒症继发ALI 具有较高的预测价值。
Abstract:
Objective　To investigate the serum levels of C-C motif chemokine ligand 25 (CCL25) and human Parkinson’s disease protein 7 (PARK7) in patients with sepsis and their relationship with acute lung injury (ALI). Methods　138 sepsis patients diagnosed and treated in Hefei Jingdongfang Hospital from February 2019 to February 2023 were selected as sepsis group. They were divided into ALI group (n=40) and non-ALI group (n=98) based on whether ALI occurred. 70 healthy individuals who underwent physical examinations at the same time were taken as a control group. Enzyme linked immunosorbent assay was used to detect serum levels of CCL25 and PARK7. The correlation between serum CCL25, PARK7 and clinical indicators were analyzed by Pearson correlation analysis. Risk factors for secondary ALI in sepsis were conducted by multivariate logistic regression analysis. The value of serum CCL25 and PARK7 levels in predicting secondary ALI in sepsis were conducted by the receiver operating characteristic curve. Results　Serum CCL25 (367.52 ± 46.87ng/L) and PARK7 (54.26 ± 17.45μg/L) in patients with sepsis was higher than that of the control group（48.17 ± 5.26ng/L，12.31 ± 4.12 μg/L），and the differences were statistically significant (t=46.825, 19.813, all P<0.05). ALI group patients CCL25 (434.65±52.87ng/L vs 340.12 ± 42.64ng/L), PARK7 (103.47 ± 22.51μg/L vs 34.18 ± 7.46 μg/L), respiratory index(1.58±0.48 vs 0.88±0.07), PaCO2(50.11±6.27mmHg vs 40.42±5.20mmHg), APACHE Ⅱ score(23.37±3.82 point vs 17.15±3.41 point) and SOFA score (13.56±2.93 point vs 10.18±2.81 point)were all higher in the non-ALI group，while oxygenation index(237.14±23.56 point vs 341.14±21.37 point) and PaO2(55.87±8.03mmHg vs 63.11±7.14mmHg) were lower in the non-ALI group, and the differences were statistically significant (t=10.998, 27.151, 14.145, 9.342, 9.385, 6.332, 25.172, 5.210，all P<0.05). The serum levels of CCL25 and PARK7 in ALI patients were positively correlated with APACHE II score，SOFA score，respiratory index and PaCO2 (r=0.579 ～ 0.801, all P<0.05), while negatively correlated with oxygenation index and PaO2 (r=-0.687, -0.643; -0.654, -0.712, all P<0.05). Serum CCL25 (OR=1.309, 95% CI: 1.040 ～ 1.646), PARK7 (OR=1.288，95% CI：1.016 ～ 1.633), APACHE II score (OR=1.188，95% CI: 1.019 ～ 1.384) and SOFA score (OR=1.197，95% CI: 1.006 ～ 1.425) were independent risk factors for secondary ALI in sepsis patients. The area under the curve (95% CI) of the combination of serum CCL25 and PARK7 for predicting secondary ALI in sepsis was 0.833 (0.784 ～ 0.872), which was greater than the individual indicators 0.770 (0.725 ～ 0.835) and 0.741 (0.691 ～ 0.790), and the differences were statistically significant (Z=4.602, 4.318, P<0.05). Conclusion　Elevated serum levels of CCL25 and PARK7 in patients with sepsis are independent risk factors affecting the occurrence of secondary ALI in sepsis. The combination of the two has high predictive value for secondary ALI in sepsis.

参考文献/References:

[1] RUDD K E, JOHNSON S C, AGESA K M, et al. Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study[J]. Lancet, 2020, 395(10219): 200-211.
[2] 洪莉, 郑青, 陈永香, 等. 脓毒症并发急性肾损伤患儿血清miR-452-3p 的水平表达及其临床意义[J]. 现代检验医学杂志, 2021, 36(6): 176-178, 182. HONG Li, ZHENG Qing, CHEN Yongxiang, et al. Expression and clinical significance of serum miR-452-3p levels in children with sepsis complicated by acute kidney injury[J]. Journal of Modern Laboratory Medicine, 2021, 36(6): 176-178, 182.
[3] WU Xue, SUN Meng, YANG Zhi, et al. The roles of CCR9/CCL25 in inflammation and inflammationassociated diseases[J]. Frontiers in Cell and Developmental Biology, 2021, 9: 686548.
[4] JIA Hongpeng, SODHI C P, YAMAGUCHI Y, et al. Toll like receptor 4 mediated lymphocyte imbalance induces nec-induced lung injury[J]. Shock, 2019, 52(2): 215-223.
[5] BHATTACHARYYA S, STURGIS J, MAMINISHKIS A, et al. Oxidation of DJ-1 cysteines in retinal pigment epithelium function[J]. International Journal of Molecular Sciences, 2022, 23(17), 9938.
[6] CHENG Yanwei, MARION T N, CAO Xue, et al. Park 7: a novel therapeutic target for macrophages in Sepsis-Induced immunosuppression[J]. Frontiers in Immunology, 2018, 9: 2632.
[7] TSOPORIS J N, AMATULLAH H, GUPTA S, et al. DJ-1 deficiency protects against sepsis-induced myocardial depression[J]. Antioxidants (Basel), 2023, 12(3): 561.
[8] 曹钰, 柴艳芬, 邓颖, 等. 中国脓毒症/脓毒性休克急诊治疗指南(2018)[J]. 感染·炎症·修复, 2019, 20(1): 3-22. CAO Yu, CHAI Yanfen, DENG Ying, et al. Emergency treatment guidelines for sepsis/septic shock in China (2018)[J]. Infection Inflammation Repair, 2019, 20(1): 3-22.
[9] 中华医学会重症医学分会. 中国严重脓毒症/脓毒性休克治疗指南(2014)[J]. 中华危重病急救医学, 2015(6): 401-426. Critical Care Medicine Society of the Chinese Medical Association. Treatment guidelines for severe sepsis/septic shock in China(2014)[J]. Chinese Critical Care Medicine, 2015(6): 401-426.
[10] GBD 2019 Antimicrobial Resistance Collaborators. Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet, 2022, 400(10369): 2221-2248.
[11] SPINNEN J, FR?HLICH K, SINNER N, et al. Therapies with CCL25 require controlled release via microparticles to avoid strong inflammatory reactions[J]. Journal of Nanobiotechnology, 2021, 19(1): 83.
[12] WANG Yuming, JI Ran, CHEN Weiwei, et al. Paclitaxel alleviated sepsis-induced acute lung injury by activating MUC1 and suppressing TLR-4/NF-κB pathway[J]. Drug Design, Development and Therapy, 2019, 13: 3391-3404.
[13] KORBECKI J, KOJDER K, BARCZAK K, et al. Hypoxia alters the expression of CC chemokines and CC chemokine receptors in a Tumor-A literature review[J]. International Journal of Molecular Sciences, 2020, 21(16): 5647.
[14] XIA Demeng, WANG Sheng, LIU Anwei, et al. CCL25 inhibition alleviates sepsis-induced acute lung injury and inflammation[J]. Infection and Drug Resistance, 2022, 15: 3309-3321.
[15] L?PEZ-PACHECO C, SOLDEVILA G, DU PONT G, et al. CCR9 is a key regulator of early phases of allergic airway inflammation[J]. Mediators of Inflammation, 2016, 2016: 3635809.
[16] YANG Jin, WANG Ying, LIU Hui, et al. C2-ceramide influences alveolar epithelial barrier function by downregulating Zo-1, occludin and claudin-4 expression[J]. Toxicology Mechanisms and Methods, 2017, 27(4): 293-297.
[17] LIND-HOLM MOGENSEN F, SCAFIDI A, POLI A, et al. PARK7/DJ-1 in microglia: implications in Parkinson’s disease and relevance as a therapeutic target[J]. Journal of Neuroinflammation, 2023, 20(1): 95.
[18] AMATULLAH H, SHAN Yuexin, BEAUCHAMP B L, et al. DJ-1/PARK7 impairs bacterial clearance in sepsis[J]. American Journal of Respiratory and Critical Care Medicine, 2017, 195(7): 889-905.
[19] GUPTA S, AMATULLAH H, TSOPORIS J N, et al. DJ-1 binds to Rubicon to impair LC-3 associated phagocytosis[J]. Cell Death and Differentiation, 2022, 29(10): 2024-2033.
[20] LIU Xiaowei, MA Tao, CAI Quan, et al. Elevation of serum PARK7 and IL-8 levels is associated with acute lung injury in patients with severe sepsis/septic shock[J]. Journal of Intensive Care Medicine, 2019, 34(8): 662-668.

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备注/Memo

备注/Memo:
基金项目：安徽省卫生健康委科研项目（AHWJ2019b055）：脓毒症急性肺损伤大鼠肺组织细胞凋亡的研究。
作者简介：阮本良（1983-），男，本科，主治医师，研究方向：重症医学科，E-mail:ruanbenliang@126.com。
更新日期/Last Update: 2024-01-15