Objective To investigate the value of neutrophil gelatinase-related lipocalin (NGAL) and autophagy-related proteinsBeclin, microtubule-associatedproteinlightchain 3Ⅱ (LC3-Ⅱ) in evaluating prognosis of elderly patients with sepsis.
Methods A total of 97 patients with sepsis were selected as sepsis group, and 97 healthy people were selected as control group. The levels of Beclin mRNA, LC3-ⅡmRNA and serum NGAL, C reactive protein (CRP) and procalcitonin (PCT) were compared between the two groups. According to the score of the Acute Physiology and Chronic Health Evaluation (APACHE Ⅱ) system, sepsis patients were divided into mild group, moderate group and severe group. The levels of various indicators were compared among the three groups, and the Pearson correlation method was used to analyze the correlations of the levels of Beclin mRNA, LC3-ⅡmRNA and NGAL with CRP, PCT, APACHE Ⅱscore and the Sequential Organ Failure Assessment Scale (SOFA) score in sepsis patients. Sepsis patients were divided into survival group and death group according to the survival status within 28 days. The levels of Beclin mRNA, LC3-ⅡmRNA, NGAL, CRP and PCT were compared between the two groups, and the values of Beclin mRNA, LC3-Ⅱ mRNA, NGAL, CRP and PCT levels in evaluating prognosis of patients were analyzed by the receiver operating characteristic (ROC) curve.
Results Compared with the control group, the levels of NGAL, CRP and PCT increased significantly in the sepsis group, while the levels of Beclin mRNA and LC3-ⅡmRNA decreased significantly (P < 0.01). With the gradual aggravation of sepsis, the levels of NGAL, CRP and PCT in the mild, moderate and severe groups increased gradually and significantly, while the levels of Beclin mRNA and LC3-ⅡmRNA decreased gradually and significantly (P < 0.01). The results of correlation analysis showed that CRP, PCT, APACHE Ⅱ score and SOFA score were positively correlated with NGAL level, and negatively correlated with Beclin mRNA and LC3-ⅡmRNA levels (P < 0.05 or P < 0.01). In sepsis patients, compared with the survival group, the levels of NGAL, CRP and PCT in the death group were significantly higher, and the levels of Beclin mRNA and LC3-Ⅱ mRNA were significantly lower (P < 0.05 or P < 0.01). ROC curve results showed that the area under the curve (AUC) of NGAL, Beclin mRNA and LC3-ⅡmRNA alone or in combination exceeded 0.8 in evaluating the prognosis of patients (P < 0.05).
Conclusion The level of NGAL in sepsis patients increases significantly while the levels of Beclin mRNA and LC3-Ⅱ mRNA decrease significantly, which are closely related to the severity of the disease and inflammatory response. The levels of NGAL, Beclin mRNA and LC3-Ⅱ mRNA show certain clinical values in evaluating the prognosis of patients.
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