| 钟铨.血清多mRNA用于脓毒症患者不良预后预测模型的构建[J].内科急危重症杂志,2026,32(4):396-399 |
| 血清多mRNA用于脓毒症患者不良预后预测模型的构建 |
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| DOI：10.11768/nkjwzzzz.202407100531 |
| 中文关键词: 脓毒症 mRNA 决策曲线分析 预后不良 |
| 英文关键词: Sepsis mRNA Decision curve analysis Poor prognosis |
| 基金项目:海南医学院第一附属医院青年培育基金项目（HYYFYPY202212） |
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| 中文摘要: |
| 摘要 目的： 探讨血清多mRNA表达对脓毒症患者预后不良的预测效能。方法：选择脓毒症患者126例，并根据患者入院28d存活情况分为死亡组和存活组，收集患者临床资料[包括人口学资料、临床资料及序贯器官衰竭评分（qSOFA）等]，检测患者血清肥大细胞表达的膜蛋白1(MCEMP1)、脯氨酸-丝氨酸-苏氨酸磷酸酶相互作用蛋白2(PSTPIP2)、颗粒钙素(GCA)、CD177 mRNA水平，分析上述mRNA与脓毒症患者预后的相关性，使用决策曲线（DCA）构建多mRNA表达水平对脓毒症患者不良预后的预测模型。结果 ：死亡组患者SOFA评分显著高于存活组（P<0.05）；MCEMP1、PSTPIP2、C D177及GCAmRNA相对表达量显著高于存活组（P均<0.05）。Cox回归分析显示：SOFA评分、MCEMP1、PSTPIP2、CD177及GCA均是影响患者预后的独立危险因素（P均<0.05）。各指标间共线性检测显示：MCEMP1、PSTPIP2、CD177及GCA之间不存在共线性关系。列线图模型预测脓毒症患者预后不良的C-index为0.983（95%Cl:0.972-1.000），区分度良好。DCA曲线结果显示多mRNA预测效能高于SOFA评分。结论：基于多mRNA构建的列线图模型对于脓毒症患者预后具有较好的预测价值。 |
| 英文摘要: |
| Abstract Objective: To investigate the predictive efficacy of multiple serum mRNA expression for poor prognosis in patients with sepsis. Methods: A total of 126 sepsis patients were enrolled and divided into a death group and a survival group according to 28-day survival. Clinical data, including demographic characteristics, clinical parameters, and the Sequential Organ Failure Assessment (SOFA) score, were collected. Serum levels of mast cell-expressed membrane protein 1 (MCEMP1), proline-serine-threonine phosphatase-interacting protein 2 (PSTPIP2), grancalcin (GCA), and CD177 mRNA were measured. The association between these mRNAs and the prognosis of sepsis patients was analyzed. A nomogram prediction model incorporating multiple mRNA expression levels was constructed, and its performance was evaluated using decision curve analysis (DCA). Results: The SOFA score in the death group was significantly higher than that in the survival group (P <0.05). The relative expression levels of MCEMP1, PSTPIP2, CD177, and GCA mRNA were significantly higher in the death group than in the survival group (all P< 0.05). Cox regression analysis revealed that the SOFA score, MCEMP1, PSTPIP2, CD177, and GCA were independent risk factors for patient prognosis (all P< 0.05). Collinearity testing demonstrated no collinearity among MCEMP1, PSTPIP2, CD177, and GCA. The nomogram model predicted poor prognosis with a C-index of 0.983 (95%CI: 0.972-1.000), indicating good discrimination. The DCA curve showed that the predictive performance of the multiple mRNA model was superior to that of the SOFA score alone. Conclusion: The nomogram model based on multiple mRNAs provides favorable predictive value for the prognosis of patients with sepsis. |
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