河北医科大学学报 ›› 2022, Vol. 43 ›› Issue (10): 1153-1157,1182.doi: 10.3969/j.issn.1007-3205.2022.10.008

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外周血自噬基因Benlin-1表达联合APACHEⅡ评分预测脓毒症患者28 d病死的研究

  

  1. 1. 河北北方学院附属第一医院急诊科，河北  张家口075000；2. 河北医科大学第二医院急诊科，河北 石家庄050000

  • 出版日期:2022-10-25 发布日期:2022-11-16
  • 作者简介:王佳（1982-），女，河北张家口人，河北北方学院附属第一医院主治医师，医学硕士，从事危重症疾病诊治研究。
  • 基金资助:
    河北省医学科学研究课题计划（20212026）

Study on autophagy gene benlin-1 expression in peripheral blood combined with APACHEⅡ score in predicting 28-day mortality of sepsis patients

  1. 1.Department of Emergency, the First Affiliated Hospital of Hebei North University, Zhangjiakou 
    075000, China; 2.Department of Emergency, the Second Hospital of 
    Hebei Medical University, Shijiazhuang 050000, China

  • Online:2022-10-25 Published:2022-11-16

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摘要： 目的 研究外周血自噬基因Benlin-1表达联合急性生理和慢性健康评分Ⅱ（Acute Physiology and Chronic Health Evaluation Ⅱ，APACHEⅡ）评分预测脓毒症患者28 d病死的价值。
方法 选取脓毒症患者238例作为脓毒症组，同期体检的健康者104例作为对照组，采用Western blot检测外周血淋巴细胞中Beclin-1的表达。根据脓毒症患者28 d病死情况分为存活患者和病死患者，采用Kaplan-Meier曲线和ROC曲线分析Beclin-1表达及APACHEⅡ评分对28 d病死的预测价值，采用COX回归模型分析脓毒症患者28 d病死的影响因素。
结果 脓毒症组外周血中Beclin-1的表达水平低于对照组（P＜0.05）；脓毒症组中病死患者外周血中Beclin-1的表达水平低于存活患者，APACHEⅡ评分高于存活患者（P＜0.05）；经Kaplan-Meier曲线和ROC曲线分析，Beclin-1表达、APACHEⅡ评分对脓毒症患者28 d病死具有预测价值；经COX分析，Beclin-1表达、APACHEⅡ评分是脓毒症患者28 d病死的影响因素；在Logistic模型中生成Beclin-1联合APACHEⅡ评分的新指标-0.566-2.238×Beclin-1+0.065×APACHEⅡ评分，该指标预测28 d病死的曲线下面积为0.6452、优于单一指标。
结论 脓毒症患者外周血Beclin-1表达及APACHEⅡ评分是脓毒症患者28 d病死的影响因素，beclin-1联合APACHEⅡ评分对28 d病死的预测价值优于单一指标。


关键词: 脓毒症, 自噬, beclin-1

Abstract: Objective To study the value of autophagy gene benlin-1 expression in peripheral blood combined with Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ) score in predicting 28-day mortality of sepsis patients. 
Methods In total, 238 patients with sepsis were selected as the sepsis group, and 104 healthy people undergoing physical examination during the same period were selected as the control group. The expression of Beclin-1 in peripheral blood lymphocytes was detected by Western blot. According to the 28-day mortality of sepsis patients, they were divided into the survival patients and the dead patients. Kaplan-Meier curve and receiver operating characteristic(ROC) curve were used to analyze the predictive value of Beclin-1 expression and APACHEⅡ score in 28-day mortality. COX regression model was used to analyze the influencing factors of 28-day mortality of sepsis patients. 
Results The expression level of Beclin-1 in peripheral blood of sepsis group was lower than that of control group(P＜0.05). The expression level of Beclin-1 in peripheral blood of dead patients in sepsis group was lower than that of survival patients, while APACHEⅡ score was higher than that of survival patients(P＜0.05). Kaplan-Meier curve and ROC curve analysis showed that Beclin-1 expression and APACHEⅡ score had predictive value for 28-day mortality of sepsis patients. COX analysis results showed that Beclin-1 expression and APACHEⅡ score were the influencing factors of 28-day mortality of sepsis patients. The new index of Beclin-1 combined with APACHEⅡ score(-0.566-2.238×Beclin-1+0.065×APACHEⅡ Score) was generated in Logistic model. The area under ROC curve of this index in predicting 28-day mortality was 0.6452, which was better than single index. 
Conclusion The expression of Beclin-1 and APACHEⅡ score are the influencing factors of 28-day mortality of sepsis patients. The predictive value of Beclin-1 combined with APACHEⅡ score in predicting 28-day mortality is superior to single index.


Key words: sepsis, autophagy, beclin-1

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