| Citation: |
JIANG Meini, LIANG Jifang, WANG Xiuzhe, ZHAO Caixia, WU Weidong. Value of neutrophil gelatinase-related lipocalin and autophagy-related protein in evaluating prognosis of elderly patients with sepsis[J]. Journal of Clinical Medicine in Practice, 2022, 26(18): 67-71, 77. DOI: 10.7619/jcmp.20220654
|
To investigate the value of neutrophil gelatinase-related lipocalin (NGAL) and autophagy-related proteins[Beclin, microtubule-associatedproteinlightchain 3Ⅱ (LC3-Ⅱ)] in evaluating prognosis of elderly patients with sepsis.
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.
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).
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.
| [1] |
AZIZM, ODEY, ZHOU M, et al. B-1a cells protect mice from Sepsis-induced acute lung injury[J]. Mol Med, 2018, 24(1): 26. doi: 10.1186/s10020-018-0029-2
|
| [2] |
DENG S Y, ZHANG L N, MO Y N, et al. Mdivi-1 attenuates lipopolysaccharide-induced acute lung injury by inhibiting MAPKs, oxidative stress and apoptosis[J]. Pulm Pharmacol Ther, 2020, 62: 101918. doi: 10.1016/j.pupt.2020.101918
|
| [3] |
ZHANG W P, JIA J C, LIU Z, et al. Circulating microRNAs as biomarkers for Sepsis secondary to pneumonia diagnosed via Sepsis 3. 0[J]. BMC Pulm Med, 2019, 19(1): 93. doi: 10.1186/s12890-019-0836-4
|
| [4] |
EMRBM, ALCAMOA M, CARCILLOJ A, et al. Pediatric Sepsis update: how are children different[J]. Surg Infect (Larchmt), 2018, 19(2): 176-183. doi: 10.1089/sur.2017.316
|
| [5] |
SCHENZ J, WEIGANDM A, UHLE F. Molecular and biomarker-based diagnostics in early Sepsis: current challenges and future perspectives[J]. Expert Rev Mol Diagn, 2019, 19(12): 1069-1078. doi: 10.1080/14737159.2020.1680285
|
| [6] |
CHANG W, ZHU S, PAN C, et al. Predictive utilities of neutrophil gelatinase-associated lipocalin (NGAL) in severe Sepsis[J]. Clin Chim Acta, 2018, 481: 200-206. doi: 10.1016/j.cca.2018.03.020
|
| [7] |
BAGSHAWS M, BENNETT M, HAASE M, et al. Plasma and urine neutrophil gelatinase-associated lipocalin in septic versus non-septic acute kidney injury in critical illness[J]. Intensive Care Med, 2010, 36(3): 452-461. doi: 10.1007/s00134-009-1724-9
|
| [8] |
HOSAKA Y, ARAYA J, FUJITA Y, et al. Chaperone-mediated autophagy suppresses apoptosis via regulation of the unfolded protein response during chronic obstructive pulmonary disease pathogenesis[J]. J Immunol, 2020, 205(5): 1256-1267. doi: 10.4049/jimmunol.2000132
|
| [9] |
ZHANG L M, AI Y H, TSUNG A. Clinical application: restoration of immune homeostasis by autophagy as a potential therapeutic target in Sepsis[J]. Exp Ther Med, 2016, 11(4): 1159-1167. doi: 10.3892/etm.2016.3071
|
| [10] |
SHANKAR-HARI M, PHILLIPSG S, LEVYM L, et al. Developing a new definition and assessing new clinical criteria for septic shock: for the third internationalconsensus definitions for Sepsis and septic shock (Sepsis-3)[J]. JAMA, 2016, 315(8): 775-787. doi: 10.1001/jama.2016.0289
|
| [11] |
DESAI S, LAKHANIJ D. Utility of SOFA and APACHEⅡscore in Sepsis in rural set up MICU[J]. J Assoc Physicians India, 2013, 61(9): 608-611.
|
| [12] |
俞凤, 赵良, 管军, 等. SOFA评分对多器官功能障碍综合征患者的预后评价作用[J]. 中国危重病急救医学, 2002, 14(8): 481-484. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWZB200208015.htm
|
| [13] |
TAN T L, GOMEZ M M, KHEIR M M, et al. Should preoperative antibiotics be tailored according to patient's comorbidities and susceptibility to organisms[J]. J Arthroplasty, 2017, 32(4): 1089-1094, e3. doi: 10.1016/j.arth.2016.11.021
|
| [14] |
NEUVILLE M, VINCLAIR C, CALLY R, et al. Place of biomarkers in the management of pulmonary infections[J]. Rev Mal Respir, 2019, 36(3): 405-414. doi: 10.1016/j.rmr.2018.09.003
|
| [15] |
PARKHS, KIMJW, LEE K R, et al. Urinary neutrophil gelatinase-associated lipocalin as a biomarker of acute kidney injury in Sepsis patients in the emergency department[J]. Clin Chim Acta, 2019, 495: 552-555. doi: 10.1016/j.cca.2019.06.005
|
| [16] |
SOYLU K, AKSAN G, NAR G, et al. Serum neutrophil gelatinase-associated lipocalin levels are correlated with the complexity and the severity of atherosclerosis in acute coronary syndrome[J]. Anatol J Cardiol, 2015, 15(6): 450-455.
|
| [17] |
MD RALIB A, MAT NOR M B, PICKERING J W. Plasma Neutrophil Gelatinase-Associated Lipocalin diagnosed acute kidney injury in patients with systemic inflammatory disease and Sepsis[J]. Nephrology (Carlton), 2017, 22(5): 412-419. doi: 10.1111/nep.12796
|
| [18] |
SUNG K, JIMENEZ-SANCHEZ M. Autophagy in astrocytes and its implications in neurodegeneration[J]. J Mol Biol, 2020, 432(8): 2605-2621. doi: 10.1016/j.jmb.2019.12.041
|
| [19] |
WANGK, CHENY, ZHANGPJ, et al. Protectivefeaturesof autophagy in pulmonary infection and inflammatory diseases[J]. Cells, 2019, 8(2): E123. doi: 10.3390/cells8020123
|
| [20] |
HSU C. Autophagy: a potential target for rescuing Sepsis-induced hepatic failure[J]. Chin J Physiol, 2019, 62(2): 53-62. doi: 10.4103/CJP.CJP_25_19
|
| 1. |
段红伟，李晓静，杨兴菊，王飞，杨逢永. 基于合成少数类过采样技术算法构建脓毒症合并急性呼吸窘迫综合征的预警模型. 中华危重病急救医学. 2024(04): 358-363 .
| |
| 2. |
刘兰，王昱. 去甲肾上腺素联合多巴胺治疗脓毒性休克患者的临床疗效及对肾功能的影响. 临床合理用药. 2023(21): 78-81 .
|
© 2020 《实用临床医药杂志》编辑部
Address: 江苏省扬州市江阳中路136号，扬州大学江阳路北校区14号楼201室China Pos: 225009Tel: 0514-87978917、87978989、87978807
Supported by:
Beijing Renhe Information Technology Co., Ltd.
苏公网安备 32100302010246号
DownLoad: