HMOX1和MAPK14与脓毒症急性肺损伤患儿发病和预后的关系

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中图分类号：R726.31 文献标志码：A DOI：10.11958/20251919

基金项目：四川省医疗卫生与健康促进科研项目（KY2022SJ0102）

The relationship between HMOX1 and MAPK14 with the onset and prognosis of sepsis-inducedacute lung injuryinchildren

LI Bo¹，LIN Hong'，HUANG Lanyingl，LI Lingyu² 1 DepartmentofPediatrics， Jiangyou People's Hospital，Jiangyou 6217Oo，China; 2Departmentof Pediatrics， Mianyang Central Hospital

Abstract：ObjectiveTo explore the relationship between the ferroptosis-related molecules heme oxygenase-1 （HMOX1）and mitogen-activated protein kinase 14（MAPK14） with the onset and prognosis of acute lung injury （ALI） in children with sepsis.MethodsAtotal of102 children with sepsis wereselected，including 54 in theALI groupand 48 in the non-ALI group. Clinical data，laboratory tests，organ function scores and serum levels of HMOX1 and MAPK14 were compared betweenthetwo groups.The mortalityratesof children with different levelsof HMOX1and MAPK14at 28-day and 90-day were analyzed.ResultsCompared with the non-ALI group，procalcitonin （PCT），lactate （Lac），pediatricorgan dysfunctionLogistic-2score（PELOD-2），pediatricriskof mortalityscore version3（PRISMII）andsequential organ failure assessment （SOFA） scores were increased in the ALI group（ P<0.05 ）.Serum levelsof HMOX1 andMAPK14were significantly higher in the ALI group than those in the non-ALI group（ P<0.05 ）.HMOX1 and MAPK14 showed good predictive value for the occurrence of ALI in sepsis patients，with AUC values of 0.872 （95 % CI： 0.791-0.930） and 0.825 （95%CI：0.737-0.893），and the optimal cutoff values were 3.1 μg/L and 3.8 μg/↕ ，respectively. After grouping by the cutoff values ofHMOX1and MAPK14，there werenosignificantdiferencesinthe28-dayand90-daymortalityratesinchildren with differentlevelsofHMOX1 and MAPK14（ P>0.05 ）.ConclusionThe expression levels of serum HMOX1 and MAPK14 increaseintheearlystageofsepsis-relatedALI，whichmayserveasbiomarkersfortheonsetofALIandtheyhave no significant impact on the prognosis of children.

Key words： sepsis; acute lung injury; ferroptosis ; heme oxygenase -1 ; mitogen-activated protein kinase 14; prognosis; child

脓毒症是宿主对感染的失调反应，其特征是炎症介质的释放和免疫功能障碍，可危及生命[1-2]。（剩余9802字）