文章摘要
李 楠,穆叶赛·尼加提,刘米莉,范 蕾,陆金帅.外周血单核细胞CHOP、NLRP3、S100A8/A9 mRNA表达水平与脓毒症患者炎症反应和预后的关系分析[J].,2022,(24):4679-4685
外周血单核细胞CHOP、NLRP3、S100A8/A9 mRNA表达水平与脓毒症患者炎症反应和预后的关系分析
Analysis of Relationship between CHOP, NLRP3 and S100A8/A9 mRNA Expression Levels in Peripheral Blood Mononuclear Cells and Inflammatory Response and Prognosis in Patients with Sepsis
投稿时间:2022-06-06  修订日期:2022-06-28
DOI:10.13241/j.cnki.pmb.2022.24.015
中文关键词: 脓毒症  炎症反应  CHOP  NLRP3  S100A8/A9  预后
英文关键词: Sepsis  Inflammatory response  CHOP  NLRP3  S100A8/A9  Prognosis
基金项目:新疆维吾尔自治区自然科学基金项目(2022D01C117)
作者单位E-mail
李 楠 新疆维吾尔自治区人民医院新疆急救中心 新疆 乌鲁木齐 830001 LLnn_19811121@163.com 
穆叶赛·尼加提 新疆维吾尔自治区人民医院新疆急救中心 新疆 乌鲁木齐 830001  
刘米莉 新疆维吾尔自治区人民医院新疆急救中心 新疆 乌鲁木齐 830001  
范 蕾 新疆维吾尔自治区人民医院新疆急救中心 新疆 乌鲁木齐 830001  
陆金帅 新疆维吾尔自治区人民医院急诊科 新疆 乌鲁木齐 830001  
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中文摘要:
      摘要 目的:探讨外周血单核细胞(PBMC)中CCAAT/增强子结合蛋白同源蛋白(CHOP)、核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)、S100A8/A9 信使核糖核酸(mRNA)表达水平与脓毒症患者炎症反应和预后的关系。方法:选取2020年1月~2022年1月新疆维吾尔自治区人民医院收治的170例脓毒症患者为脓毒症组,另选取同期68名健康体检者为对照组。采用酶联免疫吸附法检测血清白介素(IL)-6、IL-10、IL-17、IL-23、转化生长因子-β(TGF-β)水平,实时荧光定量PCR(qRT-PCR)法检测PBMC中CHOP、NLRP3、S100A8/A9 mRNA表达水平,比较脓毒症组与对照组上述指标差异。采用Pearson/Spearman相关系数分析脓毒症患者PBMC中CHOP、NLRP3、S100A8/A9 mRNA表达水平与炎症因子水平的相关性。脓毒症患者根据28d预后差异分为死亡组和存活组,收集临床资料,采用多因素Logistic回归分析脓毒症患者预后的影响因素。结果:脓毒症组PBMC中CHOP、NLRP3、S100A8/A9 mRNA相对表达量和血清IL-6、IL-10、IL-17、IL-23、TGF-β水平均明显高于对照组(P<0.05)。Pearson/Spearman相关性分析显示,脓毒症患者PBMC中CHOP、NLRP3、S100A8/A9 mRNA表达水平与血清IL-6、IL-10、IL-17、IL-23、TGF-β水平均呈正相关(P<0.05)。不同预后脓毒症患者比较,死亡组年龄大于存活组,脓毒性休克、多器官功能障碍综合征(MODS)、ICU住院时间≥10 d、机械通气时间≥3 d患者比例、脓毒症相关器官衰竭评估(SOFA)评分、血乳酸、血清IL-6、IL-10、IL-17、IL-23、TGF-β水平以及PBMC中CHOP、NLRP3、S100A8/A9 mRNA相对表达量均高于存活组,而氧合指数低于存活组(P<0.05)。多因素Logistic回归分析显示,校正其他因素后,PBMC中CHOP mRNA、NLRP3 mRNA、S100A8/A9 mRNA表达水平升高是脓毒症患者预后不良的危险因素(P<0.05)。结论:脓毒症患者PBMC中CHOP、NLRP3、S100A8/A9 mRNA呈高表达,且表达水平与炎症反应及患者预后密切相关。
英文摘要:
      ABSTRACT Objective: To investigate the relationship between the CCAAT/enhancer binding protein-homolog protein (CHOP), nucleotide binding oligomerization domain-like receptor protein 3 (NLRP3) and S100A8/A9 messenger ribonucleic acid (mRNA) expression levels in peripheral blood mononuclear cells (PBMC) and the inflammatory response and prognosis in patients with sepsis. Methods: A total of 170 patients with sepsis who were admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from January 2020 to January 2022 were selected as the sepsis group, and 68 healthy subjects during the same period were selected as the control group. The levels of serum interleukin (IL)-6, IL-10, IL-17, IL-23 and transforming growth factor-β (TGF-β) were detected by enzyme linked immunosorbent assay. The mRNA expression levels of CHOP, NLRP3 and S100A8/A9 in PBMC were detected by real-time quantitative PCR (qRT-PCR). The differences of the above indexes between sepsis group and control group were compared. Pearson/Spearman correlation coefficient was used to analyze the correlation between the CHOP, NLRP3, S100A8/A9 mRNA expression levels and inflammatory factors levels in PBMC of patients with sepsis. Patients with sepsis were divided into the death group and the survival group according to the difference in prognosis at 28d. Clinical data were collected, and the influencing factors of the prognosis of patients with sepsis were analyzed by multivariate Logistic regression. Results: The relative expression of CHOP, NLRP3, S100A8/A9 mRNA in PBMC and serum IL-6, IL-10, IL-17, IL-23 and TGF-β levels in sepsis group were significantly higher than those in the control group (P<0.05). Pearson/Spearman correlation analysis showed that the expression levels of CHOP, NLRP3 and S100A8/A9 mRNA in PBMC of patients with sepsis were positively correlated with serum IL-6, IL-10, IL-17, IL-23 and TGF-β levels (P<0.05). Compared with sepsis patients with different prognosis, the age of death group was older than that of survival group, the patients with septic shock, multiple organ dysfunction syndrome (MODS), ICU hospitalization time ≥10 d, mechanical ventilation time ≥3 d proportion, sepsis related organ failure assessment (SOFA) score, blood lactic acid, serum IL-6, IL-10, IL-17, IL-23 and TGF-β levels and CHOP, NLRP3 and S100A8/A9 mRNA in PBMC were higher than those in the survival group, while the oxygenation index was lower than that in the survival group (P<0.05). Multivariate Logistic regression analysis showed that after adjusting for other factors, the increased of CHOP mRNA, NLRP3 mRNA and S100A8/A9 mRNA expression levels in PBMC were risk factors for poor prognosis in patients with sepsis (P<0.05). Conclusion: CHOP, NLRP3 and S100A8/A9 mRNA are highly expressed in PBMC of patients with sepsis, and their expression levels are closely related to inflammatory response and prognosis.
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