Expression Levels of Plasma Lp-PLA2 and SIRT1 in Patients with Sepsis Complicated with Acute Kidney Injury and Their Relationship with Short-Term Prognosis
10.13241/j.cnki.pmb.2025.11.016
- VernacularTitle:脓毒症并发急性肾损伤患者血浆Lp-PLA2、SIRT1表达水平及其与短期预后的关系
- Author:
Xiang CHEN
1
;
Jian-zhao JIANG
1
;
Ke DING
1
;
Ying-biao DENG
1
Author Information
1. 中国人民解放军联勤保障部队第九八八医院急诊医学科 河南郑州 450007
- Publication Type:Journal Article
- Keywords:
Sepsis;
Acute kidney injury;
Lipoprotein associated phospholipase A2;
Silent information regulatory protein 1;
Short-term prognosis
- From:
Progress in Modern Biomedicine
2025;25(11):1886-1894
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the changes in plasma lipoprotein associated phospholipase A2(Lp-PLA2)and silencing information regulatory protein 1(SIRT1)in patients with sepsis complicated with acute kidney injury(AKI)and their relationship with short-term prognosis.Methods:243 sepsis patients who received treatment in our hospital from May 2022 to May 2024 were prospective selected,including 80 sepsis patients with AKI(AKI group)and 163 sepsis patients without AKI(non AKI group),the plasma Lp-PLA2 and SIRT1 levels between the two groups were compared.They were divided into good prognosis group and poor prognosis group according to 28 d prognosis after admission in AKI group.The influencing factors of short-term prognosis in sepsis patients complicated with AKI were analyzed by multiple logistic regression model.The short-term prognostic value of plasma Lp-PLA2 and SIRT1 alone and in combination for sepsis complicated with AKI patients was analyzed using receiver operating characteristic(ROC)curve.Results:Compared with non AKI group,AKI group had higher Lp-PLA2 and lower SIRT1(P<0.05).39 deaths within 28 d after admission in AKI group(poor prognosis group),41 cases survived(good prognosis group),with poor prognosis rate of 48.75%(39/80).Sequential organ failure assessment(SOFA)score,acutephysiology and chronic health evaluationⅡ(APACHEⅡ)score,creatinine(Scr),lactate dehydrogenase albumin ratio(LAR)in poor prognosis group were higher than those in good prognosis group,while procalcitonin(PCT)was lower than that in good prognosis group(P<0.05).Compared with the good prognosis group,poor prognosis group had higher Lp-PLA2 and lower SIRT1 at admission(P<0.05).Elevated SOFA score,elevated Scr,elevated APACHEⅡ score,and elevated plasma Lp-PLA2 were risk factors for poor prognosis in sepsis patients complicated with AKI(P<0.05),while elevated plasma SIRT1 was a protective factor(P<0.05).ROC curve analysis results showed that,the combined detection of plasma Lp-PLA2 and SIRT1 predicted a poor prognosis for sepsis patients with AKI with an area under the curve(AUC)of 0.935,which was better than the prediction of 0.813 and 0.858 for plasma Lp-PLA2 and SIRT1 alone.Conclusion:Sepsis complicated with AKI patients have elevated plasma Lp-PLA2 and decreased SIRT1,combined detection of the two can assist in predicting the risk of poor prognosis.