Objective To investigate the relationship between the expression of olfactomedin(OLFM)4 and OLFM1 mRNA in peripheral blood and the severity and prognosis of acute lung injury in sepsis.Methods A total of 126 patients with acute lung injury from sepsis admitted to the Tianjin Medical University Zhu Xianyi Memorial Hospital and the First Affiliated Hospital of Shihezi University from March 2019 to March 2023 were selected as the study objects.The mRNA expression of OLFM4 and OLFM1 in peripheral blood was detected by real-time fluorescence quantitative polymerase chain reaction.According to the severity of the disease,the patients were divided into low-risk group,medium-risk group and high-risk group.According to the prognosis after 28 days of treatment,the patients were divided into survival group and death group.The relationship between the expression of OLFM4 and OLFM1 mRNA in peripheral blood and the severity and prognosis of acute lung injury in sepsis was evaluated.Results Among 126 patients with acute lung injury due to sepsis,there were 26 cases in the low risk group,56 cases in the medium risk group and 44 cases in the high risk group.The relative expression levels of OLFM4 and OLFM1 mRNA in peripheral blood of the high-risk group were higher than those of the medium-risk group and the low-risk group,and the relative expression levels of OLFM4 and OLFM1 mRNA in peripheral blood of the medium-risk group were higher than those of the low-risk group(all P＜0.05).OLFM4 and OLFM1 mRNA in peripheral blood were positively correlated with disease severity(r=0.671,P=0.001;r=0.594,P=0.001).The Sequential Organ Failure Assessment(SOFA)score,Acute physiology and Chronic Health Assessment Ⅱ(APACHE Ⅱ)score,lactic acid,OLFM4 mRNA,OLFM1 mRNA in the death group were higher than those in the survival group(all P＜0.05).SOFA score(OR=4.486,95％CI:2.097-9.598),APACHE Ⅱ score(OR=3.762,95％CI:1.758-8.049),lactic acid score(OR=3.377,95％CI:1.578-7.225),OLFM4 mRNA(OR=4.464,95％CI:2.086-9.550)and OLFM1 mRNA(OR=3.869,95％CI:1.808-8.278)were the risk factors for death in patients with acute lung injury of sepsis(all P＜0.05).The sensitivity of single and combined OLFM4 and OLFM1 mRNA in peripheral blood to predict death in patients with acute lung injury of sepsis were 0.726,0.685 and 0.806,the specificity was 0.683,0.729 and 0.729,and the area under the curve was 0.782,0.772 and 0.827,respectively.Conclusions The expression of OLFM4 and OLFM1 mRNA in peripheral blood is related to the progression of the disease in patients with acute lung injury of sepsis,and it shows good predictive efficacy in the prognosis evaluation.
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