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氧化应激在脓毒症发生发展中起到重要作用,其病理过程中存在氧化还原代谢反应失衡,产生大量活性氧、氧自由基及蛋白酶等,后者又促进脓毒症的发展。Prdxs蛋白家族广泛存在原核生物和真核生物中,在清除活性氧和调节活性氧调节信号转导通路上起到主要作用。本课题组前期研究发现,脓毒症大鼠蛋白质组学中过氧化物酶(Prdx)1和Prdx6均有改变[1],但在脓毒症病人体内变化情况未见报道。本研究以临床上脓毒症病人为研究对象,观察Prdx1和Prdx6表达水平的变化,发现两者有无变化规律,以讨论Prdx1和Prdx6变化水平在脓毒症病人中的临床意义和价值。
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脓毒症休克病人血清中Prdx1水平显著高于脓毒症病人(P < 0.05)。而两者血清中Prdx6水平差异无统计学意义(P>0.05)(见表 1)。
分组 n Prdx1 Prdx6 脓毒症 46 231.6±86.4 54.6±28.7 脓毒症休克 9 531.9±153.4 66.9±30.9 t — 8.28 0.25 P — <0.05 >0.05 表 1 脓毒症与脓毒症休克病人Prdx1和Prdx6的比较($\overline x \pm s$; pg/mL)
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APACHEⅡ评分≥15分组脓毒症病人血清中Prdx1水平明显高于<15分组(P < 0.01)。而2组血清中Prdx6水平差异无统计学意义(P>0.05)(见表 2)。
分组 n Prdx1 Prdx6 ≥15分 40 437.1±280.3 54.9±25.0 <15分 15 242.8±120.1 62.7±24.6 t — 2.03 0.86 P — <0.01 >0.05 表 2 APACHEⅡ评分≥15分和<15分组间Prdx1和Prdx6的比较($\overline x \pm s$; pg/mL)
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根据预后转归分成存活组和死亡组,动态比较2组第1、3、5和7天Prdx1和Prdx6变化趋势,结果显示,存活组Prdx1水平随时间推移明显低于死亡组(P < 0.01)。除第3天外,2组Prdx6水平随时间推移差异无统计学意义(P>0.05)(见表 3)。
分组 n 第1天 第3天 第5天 第7天 F P MS组内 Prdx1 存活组 31 487.1±54.1 302.4±48.1** 232.5±44.4**## 168.3±42.8**##▲▲ 260.01 <0.01 2 260.905 死亡组 24 369.7±43.1 458.9±30.7** 549.1±27.6**## 642.1±38.1**##▲▲ 339.44 < 0.01 1 253.368 t — 8.7 13.88 30.62 42.68 — — — P — <0.01 <0.01 <0.01 <0.01 — — — Prdx6 存活组 31 62.5±11.6 68.2±11.4 88.3±9.8**## 103.0±13.8**##▲▲ 78.19 < 0.01 137.750 死亡组 24 60.3±6.2 61.8±8.4 87.8±6.8**## 102.2±6.3**##▲▲ 266.62 < 0.01 48.733 t — 0.84 2.31 0.21 0.26 — — — P — >0.05 <0.05 >0.05 >0.05 — — — q检验:与第1天比较**P < 0.01;与第3天比较##P < 0.01;与第5天比较▲▲P < 0.01 表 3 存活组和死亡组Prdx1和Prdx6变化趋势比较($\overline x \pm s$; pg/mL)
脓毒症病人血清中Prdx1和Prdx6水平变化及临床意义
Change and clinical significance of the serum levels of Prdx1 and Prdx6 in sepsis patients
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摘要:
目的探讨过氧化物酶(Prdx)1和Prdx6在脓毒症病人血清中表达水平和变化规律,以及其相关临床意义。 方法选取脓毒症病人共55例,采用酶联免疫吸附法检测入组病人第1、3、5、7天静脉血Prdx1和Prdx6表达水平,并收集相应时间的体温、白细胞计数、血小板、丙氨酸氨基转移酶、肌酐、降钙素原、C反应蛋白、急性生理与慢性健康评分、序贯器官衰竭评分,以及病人一般资料(性别、年龄、原发病、感染部位、感染细菌、有无使用去甲肾上腺素或机械通气)。 结果脓毒症休克病人血清中Prdx1水平高于脓毒症病人(P < 0.05),2组血清中Prdx6水平差异无统计学意义(P>0.05);APACHEⅡ评分≥15分组脓毒症病人血清中Prdx1水平明显高于 < 15分组(P < 0.01),而2组血清中Prdx6水平差异无统计学意义(P>0.05);第1、3、5和7天,存活组Prdx1水平随时间推移明显低于死亡组(P < 0.01),除第3天外,2组血清Prdx6水平随时间推移差异无统计学意义(P>0.05)。 结论Prdx1和Prdx6在脓毒症病人血清中表达增高,两者可能成为脓毒症病人早期诊断和治疗的分子靶点。 Abstract:ObjectiveTo investigate the changes of serum levels of Prdx1 and Prdx6 in sepsis patients and their clinical significance. MethodsThe serum levels of Prdx1 and Prdx6 in 55 patients with sepsis were determined by ELISA on the 1st, 3rd, 5th and 7th days of admission.The temperature, white blood cell count, platelet, alanine transaminase, creatinine, procalcitonin, C-reactive protein, scores of acute physiology and chronic health evaluation and sequential organ failure assessment and general data(gender, age, protopathy, infection site, pathogenic bacteria, norepinephrine use or mechanical ventilation) in all patients were analyzed at each point. ResultsThe serum level of Prdx1 in septic shock patients was higher than that in sepsis patients(P < 0.05).There was no statistical significance in serum level of Prdx6 between two groups(P>0.05).The serum level of Prdx1 in patients with APACHEⅡ score ≥ 15 was significantly higher than that in patients with APACHEⅡ score < 15(P < 0.01), the difference of the serum level of Prdx6 between two groups was not statistically significant(P>0.05).The serum levels of Prdx1 in survival group on the 1st, 3rd, 5th and 7th days were significantly lower than that in death group at time passed(P < 0.01), and except the third day, the difference of the serum level of Prdx6 between two groups was not statistical significance(P>0.05). ConclusionsThe serum levels of Prdx1 and Prdx6 in sepsis patients increase, which may become the molecular targets in the early diagnosis and treatment of sepsis. -
Key words:
- sepsis /
- peroxiredoxin /
- oxidative stress
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表 1 脓毒症与脓毒症休克病人Prdx1和Prdx6的比较(
; pg/mL)$\overline x \pm s$ 分组 n Prdx1 Prdx6 脓毒症 46 231.6±86.4 54.6±28.7 脓毒症休克 9 531.9±153.4 66.9±30.9 t — 8.28 0.25 P — <0.05 >0.05 表 2 APACHEⅡ评分≥15分和<15分组间Prdx1和Prdx6的比较(
; pg/mL)$\overline x \pm s$ 分组 n Prdx1 Prdx6 ≥15分 40 437.1±280.3 54.9±25.0 <15分 15 242.8±120.1 62.7±24.6 t — 2.03 0.86 P — <0.01 >0.05 表 3 存活组和死亡组Prdx1和Prdx6变化趋势比较(
; pg/mL)$\overline x \pm s$ 分组 n 第1天 第3天 第5天 第7天 F P MS组内 Prdx1 存活组 31 487.1±54.1 302.4±48.1** 232.5±44.4**## 168.3±42.8**##▲▲ 260.01 <0.01 2 260.905 死亡组 24 369.7±43.1 458.9±30.7** 549.1±27.6**## 642.1±38.1**##▲▲ 339.44 < 0.01 1 253.368 t — 8.7 13.88 30.62 42.68 — — — P — <0.01 <0.01 <0.01 <0.01 — — — Prdx6 存活组 31 62.5±11.6 68.2±11.4 88.3±9.8**## 103.0±13.8**##▲▲ 78.19 < 0.01 137.750 死亡组 24 60.3±6.2 61.8±8.4 87.8±6.8**## 102.2±6.3**##▲▲ 266.62 < 0.01 48.733 t — 0.84 2.31 0.21 0.26 — — — P — >0.05 <0.05 >0.05 >0.05 — — — q检验:与第1天比较**P < 0.01;与第3天比较##P < 0.01;与第5天比较▲▲P < 0.01 -
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