摘要
目的探讨血清溶质载体家族7成员11(SLC7A11)、Janus激酶2(JAK2)水平与急性非静脉曲张性上消化道出血(ANVUGIB)严重程度及预后的关系。方法选取2019年4月至2023年4月于该院接受治疗的108例ANVUGIB患者作为研究对象,根据ANVUGIB严重程度分为重度组(31例)、中度组(44例)、轻度组(33例)。根据患者预后分为预后不良组(41例)和预后良好组(67例)。另选取同期在该院进行体检的健康志愿者50例为对照组。采用酶联免疫吸附试验检测血清SLC7A11、JAK2水平,Spearman相关分析血清SLC7A11、JAK2水平与Framingham风险(FRS)、格拉斯哥-布拉奇福德出血(GBS)评分的相关性,多因素Logistic回归分析ANVUGIB患者预后不良的影响因素,受试者工作特征(ROC)曲线分析血清SLC7A11、JAK2对ANVUGIB患者预后不良的预测价值。结果3组不同严重程度的ANVUGIB患者血清SLC7A11水平均低于对照组,血清JAK2水平均高于对照组(均P<0.05)。随着病情严重程度增加,血清SLC7A11水平逐渐降低,血清JAK2水平及FRS、GBS评分逐渐升高(均P<0.05)。ANVUGIB患者血清SLC7A11水平与FRS、GBS评分均呈负相关,血清JAK2水平与FRS、GBS评分均呈正相关(均P<0.05)。预后不良组出血量>400 mL的患者占比、红细胞分布宽度、FRS评分、GBS评分、JAK2水平均高于预后良好组,血红蛋白、SLC7A11水平低于预后良好组(P<0.05)。出血量>400 mL、JAK2水平升高是ANVUGIB患者预后不良的危险因素,SLC7A11水平升高是保护因素(均P<0.05)。血清SLC7A11、JAK2联合预测ANVUGIB患者预后不良的曲线下面积优于各指标单独预测(Z_(二者联合-SLC7A11)=3.086、Z_(二者联合-JAK2)=2.330,P=0.020、0.030)。结论ANVUGIB患者血清SLC7A11水平降低、JAK2水平升高,可有效评估患者病情严重程度及预后,二者联合预测患者预后具有更高效能。
Objective To investigate the relationship between serum solute carrier family 7 member 11(SLC7A11)and Janus kinase 2(JAK2)levels and the severity and prognosis of acute non-variceal upper gastrointestinal bleeding(ANVUGIB).Methods A total of 108 patients with ANVUGIB who were treated in the hospital from April 2019 to April 2023 were selected and divided into severe group(31 cases),moderate group(44 cases)and mild group(33 cases)according to the severity of ANVUGIB.The patients were divided into poor prognosis group(41 cases)and good prognosis group(67 cases)according to their prognosis.Another 50 healthy volunteers who underwent physical examination in the hospital during the same period were selected as the control group.Serum SLC7A11 and JAK2 levels were detected by enzyme-linked immunosorbent assay.Spearman correlation analysis was used to analyze the correlation between serum SLC7A11 and JAK2 levels and Framingham risk score(FRS)and Glasweg-Blatchford bleeding score(GBS).Multivariate Logistic regression was used to analyze the influencing factors of poor prognosis in patients with ANVUGIB.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum SLC7A11 and JAK2 for poor prognosis in patients with ANVUGIB.Results The serum SLC7A11 level was significantly lower and the serum JAK2 level was significantly higher in the three groups of ANVUGIB patients than in the control group(all P<0.05).As the severity of the disease increased,the serum SLC7A11 level gradually decreased,and the serum JAK2 level,FRS and GBS scores gradually increased(all P<0.05).In ANVUGIB patients,serum SLC7A11 level was negatively correlated with FRS and GBS scores,and serum JAK2 level was positively correlated with FRS and GBS scores(all P<0.05).Compared with the good prognosis group,the poor prognosis group had significantly higher proportion of patients with bleeding volume>400 mL,red blood cell distribution width,FRS score,GBS score,and JAK2 level,and significantly lower levels of hemoglobin and SLC7A1
作者
毛晓琴
郑爱华
何盛琴
张珊
MAO Xiaoqin;ZHENG Aihua;HE Shengqin;ZHANG Shan(Department of Critical Care Medicine,Shapingba Hospital Affiliated to Chongqing University/Shapingba District People′s Hospital of Chongqing,Chongqing 400000,China;Department of Clinical Laboratory,Shapingba Hospital Affiliated to Chongqing University/Shapingba District People′s Hospital of Chongqing,Chongqing 400000,China)
出处
《国际检验医学杂志》
CAS
2024年第20期2461-2466,共6页
International Journal of Laboratory Medicine
基金
重庆市科卫教联合医学科研项目(2020FYXX224)。
