Effect of Simulated Sleep on the Expression of Circadian Clock Genes Bmal1,Per2,Immune Func-tion,and Short-term Clinical Outcomes in Patients with Sepsis
[Objective]To explore the effect of simulated sleep on the expression of circadian clock genes Brain and Muscle ARNT-Like 1(Bmal1)and Period 2(Per2),immune function,and short-term clinical outcomes in patients with sepsis.[Methods]Eighty sepsis patients were randomly divided into the control group(with stand-ard symptomatic treatment)and the observation group(with standard symptomatic treatment combined with sim-ulated sleep intervention),with 40 patients in each group.The study compared the levels of inflammatory factors[interleukin-6(IL-6),IL-8,tumor necrosis factor-alpha(TNF-α),and C-Reactive Protein(CRP)],Bmal1 and Per2 expression,immune function,Sequential Organ Failure Assessment(SOFA)score,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,mechanical ventilation duration,ICU stay duration,and 28-day mortality rate between the two groups before treatment and 7 days after treatment.[Results]After 7 days of treatment,both groups showed reduced levels of IL-6,IL-8,TNF-α,and CRP compared to before treatment(P＜0.05),with the observation group presenting even lower levels than the control group(P＜0.05).Both groups exhibited increased expression of Bmal1 and Per2 mRNA(P＜0.05)after 7 days of treatment compared to before treatment,with higher expression of Bmal1 and Per2 in the observation group than the control group(P＜0.05).The levels of CD4+,CD4+/CD8+increased,while CD8+decreased in both groups compared to before treatment(P＜0.05),and the observation group showed higher CD4+,CD4+/CD8+and lower CD8+than the control group(P＜0.05).Both groups had reduced SOFA and APACHE Ⅱ scores compared to before treatment(P＜0.05),with lower scores in the observation group(P＜0.05).The observation group had shorter mechanical ven-tilation and ICU stay durations(P＜0.05),but the difference in 28-day mortality rate was not statistically signifi-cant between the two groups(P＞0.05).[Conclusion]Simulated sleep can improve the dysregulation of circadian clock genes Bmal1 and Per2 in sepsis patients,enhance immune function,reduce systemic inflammatory response,and improve short-term clinical outcomes.
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