Correlation of HMGB1,sFLT-1 and LAR levels with 28-day clinical outcomes in patients with severe pulmonary infection-associated sepsis undergoing CRRT
10.11816/cn.ni.2025-250762
- VernacularTitle:CRRT重症肺部感染相关脓毒症患者HMGB1、sFLT-1、LAR水平与28 d临床结局的关系
- Author:
Xiping ZHOU
1
;
Lingxin DING
1
;
Xiaoqiang LIU
1
;
Honghu LIAO
1
;
Jiagui HUANG
1
Author Information
1. 重庆市南川区人民医院急诊科,重庆 408499
- Publication Type:Journal Article
- Keywords:
Sepsis;
Critical illness;
Pulmonary infection;
Continuous renal replacement therapy;
High mobility group box 1 protein;
Soluble fms-like tyrosine kinase 1;
Lactate;
Albumin;
28-day prognosis;
Predictive value
- From:
Chinese Journal of Nosocomiology
2025;35(19):2901-2905
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To investigate the levels of high-mobility group box 1(HMGB1)protein,soluble fms-like tyrosine kinase 1(sFLT-1)and lactate-to-albumin ratio(LAR)in patients with severe pulmonary infection-associ-ated sepsis undergoing continuous renal replacement therapy(CRRT),and their correlation with 28-day clinical outcomes.METHODS A total of 102 patients with severe pulmonary infection-associated sepsis undergoing CRRT admitted to the People's Hospital of Nanchuan Chongqing from Jul.2021 to Jul.2024 were enrolled.Based on 28-day clinical outcomes,they were divided into a favorable prognosis group(71 cases)and a poor prognosis group(31 cases).The levels of HMGB1,sFLT-1,lactate,albumin and LAR were compared between the two groups.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive value of HMGB1,sFLT-1 and LAR for 28-day clinical outcomes in patients with severe pulmonary infection-associated sepsis undergoing CRRT.RESULTS Gram-negative bacteria were the predominant pathogens in patients with se-vere pulmonary infection-associated sepsis undergoing CRRT.The poor prognosis group had higher lactate levels(4.01±1.07 mmol/L)and lower albumin levels(27.46±4.15 g/L)than the favorable prognosis group(P＜0.05).The levels of HMGB1(62.66±15.66 ng/ml),sFLT-1(0.71±0.17 ng/ml)and LAR(14.59±3.64％)in the poor prognosis group were significantly higher than those in the favorable prognosis group(P＜0.05).The combined detection of HMGB1,sFLT-1 and LAR yielded an area under the curve(AUC)of 0.949 for predicting poor 28-day mortality in patients with severe pulmonary infection-associated sepsis undergoing CRRT,superior to the single detection of the indexes(P＜0.05),with a sensitivity of 93.55％and specificity of 87.32％.CONCLUSIONS In patients with severe pulmonary infection-associated sepsis undergoing CRRT,gram-negative bacteria are the predominant pathogens.Patients with poor prognosis exhibit abnormally elevated levels of HMGB1,sFLT-1 and LAR,and the combined detection of these three markers demonstrates high predictive value for 28-day mortality.
