摘要
Abstract
Objective To explore the relationship between serum chemokines and levels of surfactant protein-D(SP-D),nuclear factor-κB p65 subunit nuclear translocation in peripheral blood mononuclear cells,and tumor necrosis factor-α(TNF-α),as well as their impact on prognosis,in patients with sepsis-induced multiple organ failure.Meth-ods A case-control study was conducted.A total of 186 patients with sepsis-induced multiple organ failure admitted to our hospital from January 2023 to December 2024 were selected as the case group,and 106 healthy individuals undergoing physical examinations during the same period were selected as the control group.Serum levels of CXC chemokine ligand 12(CXCL12),CXC chemokine receptor 4(CXCR4),CC chemokine ligand 20(CCL20),CC chemokine receptor 6(CCR6),SP-D,and TNF-α were detected using enzyme-linked immunosorbent assay.Immunofluorescence was used to detect the nuclear-to-cytoplasmic fluorescence intensity ratio of NF-κB p65 in peripheral blood mononuclear cells to assess the de-gree of its nuclear translocation(activation).Differences in each indicator between the two groups were compared.Correla-tions among the indicators within the case group were analyzed.Univariate and multivariate logistic regres-sion analyses were performed to identify independent risk factors for in-hospital mortality.Results Compared with the control group,patients in the case group showed significantly elevated serum levels of CXCL12,CXCR4,CCL20,CCR6,SP-D,TNF-α,and the NF-κB p65 nuclear-to-cytoplasmic ratio(all P<0.001).Within the case group,levels of CXCL12,CXCR4,CCL20,and CCR6 were positively correlated with levels of SP-D,the NF-κB p65 nuclear-to-cytoplasmic ratio,and TNF-α(all P<0.001).Univariate analysis revealed that APACHE II score,SOFA score,and levels of all the afore-mentioned measured indicators were significantly higher in the non-survivor group compared to the survivor group(all P<0.05).Multivariate logistic regression analysis further confirmed that APACHE II score(OR=2.418),CXCL12(OR=1.160),CXCR4(OR=2.382),CCL20(OR=2.074),CCR6(OR=1.684),SP-D(OR=1.081),NF-κB p65 nuclear-to-cytoplasmic ra-tio(OR=2.164),and TNF-α(OR=1.198)were independent risk factors for in-hospital mortality in patients with sepsis-in-duced multiple organ failure(all P<0.05).Conclusion Patients with sepsis-induced multiple organ failure exhibit ab-normal activation of serum chemokine axes(CXCL12/CXCR4,CCL20/CCR6),activation of the NF-κB signaling pathway(nuclear translocation),and elevated levels of SP-D and TNF-α.These indicators are not only interrelated but also consti-tute independent risk factors for patient mortality.Combined detection may contribute to a more comprehensive assessment of disease severity and prognosis risk.关键词
脓毒症/多器官功能衰竭/趋化因子Key words
sepsis/multiple organ failure/chemokines
