[1]张 囝a,徐钰行b,骆宇琛c,等.重症肺炎脓毒症患者血清Sestrin2，TLR7 水平表达及对心力衰竭的预测价值分析[J].现代检验医学杂志,2024,39(03):131-135+175.[doi:10.3969/j.issn.1671-7414.2024.03.022]
　ZHANG Jiana,XU Yuxingb,LUO Yuchenc,et al.Analysis of Serum Sestrin2 and TLR7 Level Expression in Patients with Severe Pneumonic Sepsis and Predictive Value for Heart Failure[J].Journal of Modern Laboratory Medicine,2024,39(03):131-135+175.[doi:10.3969/j.issn.1671-7414.2024.03.022]
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重症肺炎脓毒症患者血清Sestrin2，TLR7 水平表达及对心力衰竭的预测价值分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年03期
页码:
131-135+175
栏目:
论著
出版日期:
2024-05-15

文章信息/Info

Title:
Analysis of Serum Sestrin2 and TLR7 Level Expression in Patients with Severe Pneumonic Sepsis and Predictive Value for Heart Failure
文章编号:
1671-7414（2024）03-131-06
作者:
张 囝1a; 2; 徐钰行1b; 骆宇琛1c; 范琦强1a; 庞 阳2; 弓清梅1a
（1. 山西医科大学附属山西省人民医院a. 重症医学科；b. 全科；c. 呼吸与危重症医学科，太原030012；2. 河津市人民医院重症医学科，山西河津 043300）
Author(s):
ZHANG Jian1a; 2;  XU Yuxing1b;  LUO Yuchen1c;  FAN Qiqiang1a;  PANG Yang2;  GONG Qingmei1a
(1a. Department of Intensive Critical Care Medicine; 1b. Department of General Medicine; 1c. Department of Respiratory and Critical Care Medicine, Affiliated Shanxi Provincial People’s Hospital, Shanxi Medical University, Taiyuan 030012, China; 2. Department of Critical Care Medicine, Hejin People’s Hospital, Shanxi Hejin 043300, China)
关键词:
重症肺炎; 脓毒症; 心力衰竭; Sestrin2; Toll 样受体7
分类号:
R563.1；R541.6；R392.11
DOI:
10.3969/j.issn.1671-7414.2024.03.022
文献标志码:
A
摘要:
目的 探究重症肺炎脓毒症患者血清Sestrin2，Toll 样受体7（toll-like receptors 7，TLR7）水平表达及对并发心力衰竭的预测价值。方法 以2022 年2 月～ 2023 年5 月在山西省人民医院进行诊治的86 例重症肺炎脓毒症并发心力衰竭患者（并发心力衰竭组）、86 例重症肺炎脓毒症患者（未并发心力衰竭组）为研究对象，另收集同期行健康检查者86 例纳为对照组。酶联免疫吸附法（ELISA）测定血清Sestrin2 和TLR7 水平。彩色多普勒超声心动图仪测定所有受试者心功能相关指标：左室射血分数（left ventricular ejection fraction，LVEF）、左室舒张末期内径（leftventricular end diastolic diameter，LVEDD）及左室收缩末期内径（left ventricular end-systolic diameter，LESD），分析三组血清Sestrin2，TLR7 水平表达及心功能。Pearson 相关性分析并发心力衰竭患者血清Sestrin2，TLR7 水平与心功能相关指标间的关系；受试者工作特征（receiver operating characteristic，ROC）曲线分析血清Sestrin2 和TLR7 水平对重症肺炎脓毒症患者并发心力衰竭的预测价值。结果 未并发心力衰竭组与并发心力衰竭组血清Sestrin2（11.59 ± 3.31ng/ml，16.13 ± 3.62 ng/ml），TLR7（48.93 ± 9.52 ng/ml，61.74 ± 10.11 ng/ml）及心功能相关指标LVEDD（53.28 ±5.76mm，62.54 ± 6.11mm），LESD（38.16 ± 4.38mm, 48.15 ± 5.02mm）均显著高于对照组（7.11 ± 2.34ng/ml，40.12± 10.16ng/ml，44.86 ± 5.02mm，29.02 ± 4.07mm）， 差异具有统计学意义（qSestrin2=13.241，26.659，qTLR7=8.224，20.182，qLVEDD=13.824，29.028，qLESD=18.805，39.359，均P ＜ 0.05），且并发心力衰竭组患者显著高于未并发心力衰竭组，差异具有统计学意义（q=13.418，11.985，15.203，20.554，均P ＜ 0.05）；而未并发心力衰竭组和并发心力衰竭组心功能指标LVEF（55.43%± 6.62%，41.67% ± 5.84%）显著低于对照组（62.75% ± 7.16%），差异具有统计学意义（q=10.344，29.789，均P＜ 0.05），且并发心力衰竭组患者显著低于未并发心力衰竭组，差异具有统计学意义（q=19.455，P ＜ 0.05）。Pearson 相关性分析结果显示，并发心力衰竭组患者血清Sestrin2，TLR7 水平与LVEF 呈显著负相关（r=-0.419，-0.467，均P ＜ 0.05），与LVEDD 和LESD 呈显著正相关（r=0.456，0.419；0.402，0.437，均P ＜ 0.05），Sestrin2 与TLR7 呈显著正相关（r=0.641，P ＜ 0.05）。ROC 曲线结果显示，血清Sestrin2，TLR7 联合预测重症肺炎脓毒症患者并发心力衰竭的曲线下面积（area under the curve，AUC）为0.940，敏感度和特异度分别为74.9%，73.3%。结论 重症肺炎脓毒症患者血清Sestrin2，TLR7 水平均显著升高，且对患者并发心力衰竭具有良好的预测价值。
Abstract:
Objective To investigate the expression of serum Sestrin2 and Toll-like receptor 7 (TLR7) in patients with severe pneumonia and sepsis and their predictive value for heart failure. Methods A total of 86 patients with severe pneumonia and sepsis complicated with heart failure (complicated with heart failure group) and 86 patients with severe pneumonia and sepsis (uncomplicated with heart failure group) who were diagnosed and treated in Shanxi Provincial People’s Hospital from February 2022 to May 2023 were studied. Another 86 patients who underwent health examinations were included as the control group.Enzyme linked immunosorbent assay（ELISA）method was applied to measure serum levels of Sestrin2 and TLR7. Color doppler echocardiography was applied to measure cardiac function related indicators: left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), and left ventricular end systolic diameter (LESD). The expression of Sestrin2 and TLR7 levels and cardiac function in three groups was analyzed. Pearson correlation was applied to analyze the relationship between serum levels of Sestrin2 and TLR7 and cardiac function related indicators in patients with heart failure. Receiver operating characteristic (ROC) curve was applied to analyze the predictive value of serum levels of Sestrin2 and TLR7 in patients with severe pneumonia and sepsis complicated with heart failure. Results The serum levels of Sestrin2 (11.59 ± 3.31 ng/ml, 16.13±3.62 ng/ml), TLR7 (48.93 ± 9.52 ng/ml, 61.74 ± 10.11 ng/ml), and cardiac function related indicators [LVEDD (53.28±5.76 mm, 62.54±6.11 mm) and LESD (38.16±4.38 mm, 48.15±5.02 mm)] were higher in uncomplicated heart failure group and complicated heart failure group than those in control group (7.11±2.34 ng/ml, 40.12±10.16 ng/ml, 44.86±5.02 mm, 29.02±4.07 mm), with significant differences (qSestrin2=13.241, 26.659, qTLR7=8.224, 20.182, qLVEDD=13.824, 29.028, qLESD=18.805, 39.359, all P<0.05), and those values in complicated with heart failure group were higher than those in uncomplicated with heart failure group, with significant differences (q=13.418, 11.985, 15.203, 20.554, all P<0.05). The LVEF (55.43%±6.62%, 41.67%±5.84%) index in uncomplicated heart failure group and complicated heart failure group was lower than that in control group (62.75%±7.16%), with significant differences (q=10.344, 29.789, all P<0.05), and the index in complicated with heart failure group was lower than that in uncomplicated with heart failure group, with significant difference (q=19.455, P<0.05). Pearson correlation analysis showed that serum levels of Sestrin2 and TLR7 in patients with heart failure were negatively correlated with LVEF (r=-0.419, -0.467, all P<0.05), and positively correlated with LVEDD and LESD (r=0.456, 0.419; 0.402, 0.437, all P<0.05). Sestrin2 was positively correlated with TLR7 (r=0.641, P<0.05). ROC curve results showed that the area under the curve (AUC) of serum Sestrin2 combined TLR7 for predicting heart failure in severe pneumonia sepsis patients was 0.940, with sensitivity of 74.9% and specificity of 73.3%. Conclusion The serum levels of Sestrin2 and TLR7 in patients with severe pneumonia and sepsis were elevated and may have good predictive value for patients with heart failure.

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备注/Memo

备注/Memo:
项目基金：山西省卫生计生委科研课题（2017026）：脓毒症患者左心室结构和功能变化特点及其临床意义探讨。
作者简介：张囝（1984-），男，本科，主治医师，研究方向：呼吸疾病，E-mail：sx25c49@163.com。
通讯作者：弓清梅（1970-），女，硕士研究生，主任医师，研究方向：重症感染，E-mail：ty_gqm@163.com。
更新日期/Last Update: 2024-05-15