血浆线粒体DNA水平与脓毒症患儿病情严重程度及预后的相关性

doi:10.3969/j.issn.1006-6233.2022.10.019

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Abstract Objective: To analyze the correlation between plasma mitochondrial DNA (mt-DNA) levels and the severity and prognosis of children with sepsis,and to find valuable biomarkers. Methods: A total of 103 children with sepsis in the pediatric intensive care unit (ICU) of our hospital from January 2021 to March 2022 were selected as the research subjects.According to the severity,they were divided into the sepsis group with 57 cases and the severe sepsis group with 46 cases.50 cases of ICU infected children matched by gender and age during the same period were set as the infection group,and healthy children matched by gender and age during the same period were used as the control group.Plasma mt-DNA,calcitoninogen (PCT),C-reactive protein (CRP) and lactate (Lac) levels were compared between the groups. The critical illness score (PCIS),the 2nd generation Paediatric Organ Dysfunction Score (PELOD-2) and the 3rd generation Paediatric Risk of Mortality Score (PRISM III) of 57 cases in the sepsis group were compared,and the correlation between plasma mt-DNA and PCT,CRP,Lac levels and PCIS scores was analysed. According to the outcome 28 days after admission,the children were divided into a survival group and a death group.The plasma mt-DNA,PCT,CRP and Lac levels were compared between the two groups,and ROC curves were established to analyse the predictive value of plasma mt-DNA,PCT,CRP and Lac on the prognosis of children with sepsis. Results: There were significant differences in the levels of mt-DNA,PCT,CRP and Lac among the groups (P<0.05).Pairwise comparison of mt-DNA levels between groups:the severe sepsis group was higher than the sepsis group,the infection group and the control group; the sepsis group was higher than the infection group and the control group; the infection group was higher than the control group,the differences were all Statistical significance (P<0.05).Pairwise comparison of PCT,CRP and Lac levels between groups:the severe sepsis group was higher than the sepsis group,the infection group and the control group; the sepsis group and the infection group were higher than the control group,and the Lac level in the sepsis group was higher than In the infection group,the difference was statistically significant (P<0.05).There was no significant difference in the levels of PCT and CRP between the sepsis group and the infection group (P>0.05).The PCIS score in the severe sepsis group was lower than that in the sepsis group,the PELOD-2 and PRISMIII scores were higher than those in the sepsis group,and the differences were statistically significant (P<0.05).Plasma mt-DNA was positively correlated with PCT,CRP,Lac,PELOD-2 and PRISMⅢ scores (r=0.877,0.904,0.875,0.923,0.870,all P=0.000).Plasma mt-DNA was negatively correlated with PCIS score (r=-0.841,P=0.000).The plasma levels of mt-DNA,PCT,CRP and Lac in the death group were higher than those in the survival group,and the differences were statistically significant (P<0.05).The ROC curve was established.When the cut-off of plasma mt-DNA,PCT,CRP,and Lac levels were 1124.28 pg/mL,18.49ng/mL,27.38mg/L,and 3.04 mmoL/L,Youden was the highest,with AUCs of 0.817 and 0.716,,0.607,0.759 respectively.The sensitivity of plasma mt-DNA in predicting the prognosis of sepsis was 80.95%,which was significantly higher than 71.43%,66.67% and 76.19% of PCT,CRP and Lac; the specificity of plasma mt-DNA in predicting the prognosis of sepsis was 93.90%.It was significantly higher than 81.71%,75.61% and 74.39% of PCT,CRP and Lac,and the differences were statistically significant (P<0.05). Conclusion: There are significant differences in mt-DNA in children with sepsis of different severity and prognosis.Plasma mt-DNA can be used as a biomarker for the early diagnosis of sepsis as it can help to assess the severity and prognosis of septic children.

Key words： Mitochondrial DNA Sepsis Children Condition Prognosis

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2022.10.019 OR http://www.hbyxzzs.cn/EN/Y2022/V28/I10/1678

[1] Wu Z,Liang Y,Li Z,et al.Accuracy comparison between age-adapted SOFA and SIRS in predicting in-hospital mortality of infected children at China's PICU[J].Shock,2019,52(3):347-352.
[2] Levy MM,Evans LE,Rhodes A.The Surviving Sepsis Campaign bundle:2018 update[J].Crit Care Med,2018,46(6):997-1000.
[3] 杨毅,姚鑫儿,杨静娟,等.血浆游离线粒体DNA拷贝数与脓毒症患者序贯器官衰竭评估评分的关联研究[J].中华急诊医学杂志,2019,28(3):366-369.
[4] 王鹏飞,李硕,王瑞鹃,等.外周血线粒体DNA与慢性心力衰竭病情及近期预后的关系[J].中国医刊,2021,56(4):382-385.
[5] 葛晨,刘俊行,付优,等.微小RNA-21对脓毒症急性肺损伤小鼠肺组织的修复作用及其与PTEN的关系[J].山东医药,2022,62(2):30-34.
[6] Dellinger RP,Levy MM,Rhodes A,et al.Surviving sepsis campaign:imternational guidelines for manage-ment of severe sepsis and septic shock,2012[J].Inten-sive Care Med,2013,39(2):165-228.
[7] 王丽,徐利,刘锋瑞.热休克蛋白70基因多态性与脓毒症患者病情严重程度及预后的相关性研究[J].中国急救医学,2019,39(4):327-331.
[8] 陈小莹,陈忆青.系统免疫炎症指数在脓毒症严重程度和预后判断中的应用价值[J].中国医药,2021,16(6):893-896.
[9] 武秀梅,马英,乔晓霞,等.严重脓毒症患儿血清白蛋白和降钙素原与危重度及预后的关系[J].中国妇幼健康研究,2022,33(5):107-111.
[10] 唐甜,李少军,郭鹏飞,等.ODN2088减轻线粒体DNA致脓毒症大鼠急性肺损伤[J].儿科药学杂志,2021,27(3):1-6.
[11] 李超,李妮妮,吕红霞,等.微小RNA-122a、微小RNA-133a-3P与脓毒症患者严重程度、预后的关系[J].中国临床医生杂志,2022,50(5):586-588.
[12] 马海艳,刘学文,付盈菊,等.外周血线粒体DNA、miR-223水平与脓毒症患者病情严重程度的关系及对预后的评估价值[J].中华医院感染学杂志,2022,32(4):491-495.
[13] 黄嵘,徐芳媛,方向群,等.急诊脓毒症严重程度评分对ICU脓毒症患者预后的预测价值[J].浙江医学,2021,43(2):176-179.
[14] 周亮,谭利平.线粒体DNA在脓毒症相关性ALI/ARDS发病机制中的作用[J].中华危重病急救医学,2020,32(2):253-256.