血清PKM2、Gal-3、CitH3水平升高可预测机械通气并发肺部感染

doi:10.16352/j.issn.1001-6325.2025.01.0086

基础医学与临床 ›› 2025, Vol. 45 ›› Issue (1): 86-90.doi: 10.16352/j.issn.1001-6325.2025.01.0086

血清PKM2、Gal-3、CitH3水平升高可预测机械通气并发肺部感染

黄航栋^*, 厉丹瑜, 朱晓锋

金华市中心医院重症医学科,浙江金华 321000

收稿日期:2024-05-27 修回日期:2024-10-07 出版日期:2025-01-05 发布日期:2024-12-25
通讯作者: ^*huanghd06@163.com
基金资助:
2021年浙江省医师协会临床研究基金(YS2021-1-016)

Elevated levels of serum PKM2, Gal-3 and CitH3 could predict pulmonary infection complicated by mechanical ventilation

HUANG Hangdong^*, LI Danyu, ZHU Xiaofeng

Department of Intensive Care, Jinhua Central Hospital, Jinhua 321000, China

Received:2024-05-27 Revised:2024-10-07 Online:2025-01-05 Published:2024-12-25
Contact: ^*huanghd06@163.com

摘要/Abstract

摘要： 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。

关键词: 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

Abstract: Objective To investigate the relationship between serum level of pyruvate kinase M2 (PKM2), galectin-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 infection 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 patients 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 prognosis 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 combined 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.

Key words: mechanical ventilation, pulmonary infection, pyruvate kinase M2(PKM2), galectin-3(Gal-3), citrullinated histone H3(CitH3), prognosis

中图分类号:

R563

黄航栋, 厉丹瑜, 朱晓锋. 血清PKM2、Gal-3、CitH3水平升高可预测机械通气并发肺部感染[J]. 基础医学与临床, 2025, 45(1): 86-90.

HUANG Hangdong, LI Danyu, ZHU Xiaofeng. Elevated levels of serum PKM2, Gal-3 and CitH3 could predict pulmonary infection complicated by mechanical ventilation[J]. Basic & Clinical Medicine, 2025, 45(1): 86-90.

参考文献

[1] 林雨琪, 易杰. 喉罩全麻最佳机械通气模式的研究进展[J]. 基础医学与临床, 2023, 43:842-847.
[2] Esen I, Jiemy WF, van Sleen Y, et al. Plasma pyruvate Kinase M2 as a marker of vascular inflammation in giant cell arteritis[J]. Rheumatology (Oxford), 2022, 61:3060-3070.
[3] 李斐, 郭珊, 郭利敏, 等. 不同病原体感染肺炎患儿血清sRAGE、Gal-3表达变化及临床意义[J]. 中国病原生物学杂志, 2024, 19:79-82,87.
[4] 罗芮芮, 杨爱祥, 周碧莹, 等. 血清瓜氨酸化组蛋白H3和沉默信号调节因子1检测在急性脓毒症患者病情及预后评估中的应用研究[J]. 临床和实验医学杂志, 2024, 23:24-28.
[5] 中华医学会呼吸病学分会感染学组. 中国成人医院获得性肺炎与呼吸机相关性肺炎诊断和治疗指南(2018年版)[J]. 中华结核和呼吸杂志, 2018, 41:255-280.
[6] Liu Z, Le Y, Chen H, et al. Role of PKM2-mediated immunometabolic reprogramming on development of cytokine storm[J]. Front Immunol, 2021, 12:1-21.
[7] Allen CNS, Santerre M, Arjona SP, et al. SARS-CoV-2 causes lung inflammation through metabolic reprogram-ming and RAGE[J]. Viruses, 2022, 14:1-15.
[8] Li C, Deng C, Wang S, et al. A novel role for the ROS-ATM-Chk2 axis mediated metabolic and cell cycle reprogramming in the M1 macrophage polarization[J]. Redox Biol, 2024, 70:1-21.
[9] Bouffette S, Botez I, De Ceuninck F. Targeting Gal-3 in inflammatory and fibrotic diseases[J]. Trends Pharmacol Sci, 2023, 44:519-531.
[10] Rotshenker S. Gal-3 (MAC-2) controls phagocytosis and macropinocytosis through intracellular and extracellular mechanisms[J]. Front Cell Neurosci, 2022, 16:1-15.
[11] Feng C, Cross AS, Vasta GR. Galectin-1 mediates interactions between polymorphonuclear leukocytes and vascular endothelial cells, and promotes their extravasation during lipopolysaccharide-induced acute lung injury[J]. Mol Immunol, 2023, 156:127-135.
[12] Cervantes-Alvarez E, la Rosa NL, la Mora MS, et al. Gal-3 as a potential prognostic biomarker of severe COVID-19 in SARS-CoV-2 infected patients[J]. Sci Rep, 2022, 12:1-9.
[13] Park Y, Ryu B, Deng Q, et al. An integrated plasmo-photoelectronic nanostructure biosensor detects an infection biomarker accompanying cell death in neutrophils[J]. Small, 2020, 16:1-10.
[14] Zuo Y, Yalavarthi S, Shi H, et al. Neutrophil extracellular traps in COVID-19[J]. JCI Insight, 2020, 5:1-11.

[1]	李顺乐, 李蓉, 田亚亚, 冉小丽, 赵延培, 徐蒙. 血清KLF5和actinin-4水平与肝细胞肝癌肝动脉化疗栓塞术治疗预后的关系[J]. 基础医学与临床, 2024, 44(9): 1284-1289.
[2]	侯楠, 刘源, 高俊, 王晶, 袁萌. 全血NPM1、MCP-1和肠道菌群与胃癌进展及预后相关[J]. 基础医学与临床, 2024, 44(8): 1137-1142.
[3]	操辰新, 唐辉, 耿瑞璇, 郭伏平, 白春梅, 王颖轶, 李太生. 循环CD4⁺CD45RA⁺CD62L⁺ T细胞与接受EGFR-TKI治疗的转移性非小细胞肺癌预后相关[J]. 基础医学与临床, 2024, 44(5): 658-664.
[4]	丁飞, 王洒, 黄常新. 非小细胞肺癌患者血清CA211水平和NK细胞数与预后相关[J]. 基础医学与临床, 2024, 44(2): 180-184.
[5]	宋礼坡, 王春梅. 电阻抗断层成像指导机械通气呼吸末正压设置的研究进展[J]. 基础医学与临床, 2024, 44(11): 1492-1498.
[6]	张伟, 张振, 杨连任, 梁伟. 肺癌7项抗体水平与NSCLC患者化疗效果及预后的关系[J]. 基础医学与临床, 2024, 44(10): 1383-1387.
[7]	周昕羽, 汤继宏, 肖潇, 冯隽, 杨乐天, 徐欢, 武银银. 儿童急性B淋巴细胞白血病合并化疗诱导周围神经病变的临床特点及预后分析[J]. 基础医学与临床, 2024, 44(10): 1394-1399.
[8]	依马木买买提江·阿布拉, 帕哈尔丁·白克热, 易超, 佟庆. 血浆hsa_circ_005230在原发性肝细胞癌诊断和预后评估中的临床价值[J]. 基础医学与临床, 2023, 43(9): 1417-1422.
[9]	贡子琦, 吴晓雯, 郭倩, 郭军, 孔燕. PTEN突变对黏膜黑色素瘤患者临床病理特征及预后的影响[J]. 基础医学与临床, 2023, 43(9): 1341-1345.
[10]	张永梅, 张志敏, 周洁, 潘志兰, 冯丽倩, 杨彦. LncRNA CBR3-AS1在多发性骨髓瘤中的表达及临床意义[J]. 基础医学与临床, 2023, 43(6): 948-952.
[11]	薛剑超, 王亚东, 李博文, 刘新宇, 梁乃新, 李单青. DNA甲基化在肺癌发生及预后中作用的研究进展[J]. 基础医学与临床, 2023, 43(3): 514-518.
[12]	谢晓婷, 张雷, 张莉, 董凤, 刘颖, 李光华, 杨兴. ASH2L在幽门螺旋杆菌感染的人胃癌细胞系中的表达及临床意义[J]. 基础医学与临床, 2023, 43(3): 367-373.
[13]	李雨喋, 王宏宇, 韩松, 李俊发. 激活素A通过少突胶质细胞ACVR1C改善缺血性卒中小鼠神经功能的预后[J]. 基础医学与临床, 2023, 43(3): 380-385.
[14]	孙爱华, 赵艳秋, 王继灵. 老年慢性阻塞性肺部疾病急性加重期患者住院死亡的危险因素及预后[J]. 基础医学与临床, 2022, 42(9): 1414-1418.
[15]	谢思安, 陈奕阳, 徐俊玄, 宁婷婷, 张楠, 朱圣韬, 张澍田. PTOV1表达水平对结直肠癌患者预后的影响[J]. 基础医学与临床, 2022, 42(8): 1176-1181.

血清PKM2、Gal-3、CitH3水平升高可预测机械通气并发肺部感染

Elevated levels of serum PKM2, Gal-3 and CitH3 could predict pulmonary infection complicated by mechanical ventilation

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价