Correlations of serum autotaxin,angiopoietin like protein 4,S100 calcium-binding protein A12 and NLRP3 in-flammatory bodies with prognosis in patients with sepsis complicated with acute respiratory distress syndrome

YAN Sha; ZHU Ya; YANG Jian-xu; FU Yu-ping; NIU Xiao-bin; LI Yong-wei

doi:10.13820/j.cnki.gdyx.20225602

Abstract：Objective To investigate the correlations of serum autotaxin(ATX),angiopoietin-like protein 4(Angptl4),S100 calcium-binding protein A12(S100A12)and NOD-like receptor pyrin domain containing 3(NLRP3)inflammasome with the prognosis in patients with sepsis complicated with acute respiratory distress syndrome(ARDS).Methods From January 2019 to April 2022,303 patients with sepsis were selected,and were divided into ARDS group(106 cases)and non-ARDS group(197 cases)according to whether they had ARDS or not.The serum ATX,Angptl4,S100A12,NLRP3 and the cytokines interleukin(IL)-1β and IL-18 levels were compared between the two groups.The correlations of serum ATX,Angptl4,S100A12 levels with NLRP3,IL-1β and IL-18 levels were ana-lyzed by Pearson correlation coefficient.According to the prognosis of patients in the ARDS group during hospitalization,they were divided into survival group(57 cases)and death group(49 cases).The clinical data of the two groups were an-alyzed,and the risk factors of patients with sepsis complicated with ARDS during hospitalization were analyzed by logistic regression analysis model.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of ser-um ATX,Angptl4 and S100A12 alone and in combination for in-hospital death of patients with sepsis complicated with ARDS.Results Serum ATX,Angptl4,S100A12,NLRP3,IL-1β and IL-18 levels in the ARDS group were signifi-cantly higher than those in the non-ARDS group(P＜0.05).Pearson analysis showed that serum ATX,Angptl4 and S100A12 were positively correlated with NLRP3 mRNA,IL-1β and IL-18 levels(P＜0.05).The proportion of age,acute physiological and chronic health score Ⅱ(APACHE Ⅱ),sequential organ failure assessment(SOFA)score,blood lactic acid,serum ATX,Angptl4,S100A12 levels,shock,mechanical ventilation time ≥3 d,ICU stay time ≥10 d,in-vasive catheterization of patients in the death group were significantly higher than those in the survival group;while the ox-ygenation index(OI)and albumin level were significantly lower than those in the survival group(P＜0.05).Multivariate logistic regression analysis showed that the elevated of APACHE Ⅱ on admission,SOFA score,serum ATX,Angptl4 and S100A12 were all risk factors for death(P＜0.05).ROC curve analysis showed that the areas under curve(AUC)of ATX,Angptl4,S100A12 and their combination in predicting the in-hospital death of patients with sepsis complicated with ARDS were 0.729,0.708,0.780 and 0.852,respectively;the combined predictive efficacy of the three serum inde-xes was higher than that of the single detection.Conclusion The serum levels of ATX,Angptl4 and S100A12 in patients with sepsis complicated with ARDS are increased,which are closely related to NLRP3 inflammasome and its cytokines,and are independent risk factors affecting the outcome of the disease during hospitalization.Combined detection of serum ATX,Angptl4 and S100A12 is helpful to the short-term prognosis of patients with sepsis complicated with ARDS.