Prognostic value of ratio of monocyte to high-density lipoprotein combined with high mobility group protein B1 in patients with septic myocardial injury

Objective To explore the value of ratio of monocyte to high-density lipoprotein(MHR) combined with high mobility group protein B1 (HMGB1)for predicting myocardial injury in septic patients.

Methods A total of 100 patients with sepsis were selected as study objects, and were divided into myocardial injury group(40 cases) and without myocardial injury group (60 cases) according to whether the patients complicated with myocardial injury or not. Another 90 healthy people in the same period were selected as control group. The serum levels of MHR and HMGB1 were compared among three groups. Univariate analysis and multivariate Logistic regression analysis were used to explore the influencing factors of sepsis patients complicating with myocardial injury. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of MHR and HMGB1 on myocardial injury in sepsis patients.

Results Compared with the control group, the levels of MHR and HMGB1 were increased in the myocardial injury group and without myocardial injury group, the levels of MHR and HMGB1 in the myocardial injury group were higher than those in the without myocardial injury group(P < 0.05). Acute Physiology and Chronic Health Status Score System Ⅱ (APACHEⅡ) score, Sequential Organ Failure Assessment (SOFA) score and cardiac troponin Ⅰ (cTnⅠ), amino-terminal brain natriuretic peptide precursor (NT-proBNP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) levels were higher in the myocardial injury group were higher than those in the without myocardial injury group (P < 0.05). Multivariate Logistic regression analysis showed that APACHE Ⅱ score, SOFA score, NT-proBNP, cTnⅠ, IL-6 and TNF-α were independent influencing factors of myocardial injury in sepsis patients (P < 0.05). ROC curve analysis showed that MHR combined with HMGB1 had a higher value in predicting myocardial injury in sepsis patients than MHR and HMGB1 alone (P < 0.05).

Conclusion The expression levels of MHR and HMGB1 in serum of sepsis patients with myocardial injury are increased, and the combination of MHR and HMGB1 can effectively predict myocardial injury in patients with sepsis. According to the main risk factors of myocardial injury in patients with sepsis, the formulation and implementation of targeted measures are of positive significance to improve the prognosis of patients.