首页|血清PKM2、Gal-3、CitH3水平升高可预测机械通气并发肺部感染

血清PKM2、Gal-3、CitH3水平升高可预测机械通气并发肺部感染

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目的 探讨血清丙酮酸激酶M2(PKM2)、乳糖凝集素-3(Gal-3)、瓜氨酸化组蛋白H3(CitH3)水平与机械通气(MV)患者并发肺部感染的关系及预后评估价值。方法 将 2022 年 10 月至 2024 年 3 月于金华市中心医院收治的120 例行MV的患者纳入研究,根据是否并发肺部感染分为肺部感染组(n=50)和非肺部感染组(n=70),ELISA检测血清PKM2、Gal-3、CitH3 水平;收集临床资料;预后随访并分为预后良好组(n=79)和预后不良组(n=41);多因素Logistic回归分析影响MV患者发生预后不良的因素;受试者工作特征(ROC)曲线分析血清PKM2、Gal-3、CitH3对MV患者发生预后不良的预测价值。结果 与非肺部感染组相比,肺部感染组血清PKM2、Gal-3、CitH3 水平均升高(P<0。05);与预后良好组相比,预后不良组血清PKM2、Gal-3、CitH3 水平均升高(P<0。05);预后不良组较预后良好组临床肺部感染评分(CPIS)升高(P<0。05);PKM2、Gal-3、CitH3 皆为 MV 患者发生预后不良的危险因素(P<0。05);PKM2、Gal-3、CitH3 及联合预测患者发生预后不良的曲线下面积(AUC)分别为 0。712、0。839、0。779、0。925,3 者联合诊断的AUC优于各自单独检测(Z=4。261、2。521、3。676,P<0。001、0。05、0。001)。结论 MV并发肺部感染患者血清PKM2、Gal-3、CitH3 水平均较未发生肺部感染患者升高,三者对MV患者发生预后不良有一定的预测价值。
Elevated levels of serum PKM2,Gal-3 and CitH3 could predict pulmonary infection complicated by mechanical ventilation
Objective To investigate the relationship between serum level of pyruvate kinase M2(PKM2),galec-tin-3(Gal-3)and citrolinated histone H3(CitH3)and pulmonary infection in patients with mechanical ventilation(MV).Methods A total of 120 patients with MV admitted to Jinhua Central Hospital from October 2022 to March 2024 were included in the study.They were divided into pulmonary infection group(n=50)and non-pulmonary in-fection group(n=70).Serum level of PKM2,Gal-3 and CitH3 was detected by ELISA.The patients were divided into good prognosis group(n=79)and bad prognosis group(n=41).Multivariate Logistic regression analysis was performed to analyze the factors affecting the adverse prognosis of MV patients.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum PKM2,Gal-3 and CitH3 for poor prognosis in pa-tients undergoing MV.Results Compared with non-pulmonary infection group,serum level of PKM2,Gal-3 and CitH3 in pulmonary infection group was increased(P<0.05).The level of serum PKM2,Gal-3 and CitH3 in the poor prognosis group was increased(P<0.05).The Clinical Pulmonary Infection score(CPIS)of the poor progno-sis group was higher than that of the good prognosis group(P<0.05).PKM2,Gal-3 and CitH3 were all risk factors for poor prognosis in MV patients(P<0.05).The area under the curve(AUC)of PKM2,Gal-3,CitH3 and com-bined prediction of poor prognosis were 0.712,0.839,0.779 and 0.925,respectively.AUC of combined diagnosis of PKM2,GAL-3,CITH3 and combined diagnosis was better than that of single detection(Z=4.261,2.521,3.676,P<0.001,0.05,0.001).Conclusions The serum level of PKM2,Gal-3,and CitH3 in MV patients with concurrent pulmonary infections is found to be higher than those in those without pulmonary infections,so these three factors have potential predictive value for poor prognosis of MV patients.

mechanical ventilationpulmonary infectionpyruvate kinase M2(PKM2)galectin-3(Gal-3)citrullinated histone H3(CitH3)prognosis

黄航栋、厉丹瑜、朱晓锋

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金华市中心医院 重症医学科,浙江 金华 321000

机械通气 肺部感染 丙酮酸激酶M2(PKM2) 乳糖凝集素-3(Gal-3) 瓜氨酸化组蛋白H3(CitH3) 预后

2025

基础医学与临床
北京生理科学会

基础医学与临床

影响因子:0.669
ISSN:1001-6325
年,卷(期):2025.45(1)