Influencing factors for prognosis of septic shock patients and values of circulating histones and NLRP3 inflammasome in prediction of prognosis
OBJECTIVE To investigate the risk factors for adverse prognosis of the patients with septic shock and explore the association of circulating histones and NOD-like receptor thermal protein domain associated protein 3(NLRP3)with the prognosis.METHODS A total of 80 patients with septic shock who were treated in Jinhua Cen-tral Hospital from Oct 2020 to Feb 2023 were enrolled in the study and were divided into the survival group with 43 cases and the death group with 37 cases according to the prognosis.The distribution of pathogens was ob-served,multivariate logistic regression analysis was performed for influencing factors for the prognosis.The val-ues of the peripheral blood circulating histones and NLRP3 inflammasome in prediction of the prognosis were ana-lyzed by means of receiver operating characteristic(ROC)curves.RESULTS Totally 93 strains of pathogens were isolated from the 80 patients with septic shock,61(65.59％)of which were gram-negative bacteria,24(25.81％)were gram-positive bacteria,and 8(8.60％)were fungi.The result of multivariate analysis showed that no less than 60 years of age,high grade of multiple organ dysfunction syndrome(MODS)score,circulating histones and NLRP3 were the influencing factors for death of the patients with septic shock(P＜0.05).ROC curve analysis indicated that the sensitivity and specificity of the circulating histones were respectively 85.82％and 83.93％in prediction of adverse prognosis when the critical value was 0.30 mg/L,with the area under curve(AUC)0.881.The sensitivity and specificity of the NLRP3 inflammasome were respectively 88.37％and 67.57％in prediction of adverse prognosis when the critical value of relative expression of mRNA was 1.98,with the AUC 0.823.CONCLUSION The old age,high score of MODS,circulating histones and NLRP3 may increase the risk of death of the patients with septic shock.The circulating histones and NLRP3 inflammasome can be used as the indexes for early prediction of prognosis of the septic shock patients.
Circulating histoneNOD-like receptor thermal protein domain associated protein 3Septic shockPrognosisPathogenInfluencing factorClinical value
NETL
NSTL
万方数据
维普
