Changes of serum heat shock protein 70 and heme oxygenase-1 in patients with sepsis-induced gastrointestinal dys-function and influence on disease conditions

Sun Aqiao; Li Minling; Tan Wenjun; Song Ye; Zhang Yunling; Song Yinxue

doi:10.3969/j.issn.1671-6450.2025.04.004

Abstract：Objective To explore the changes and significance of serum heat shock protein 70(HSP70)and heme oxygenase-1(HO-1)in patients with sepsis-induced gastrointestinal dysfunction.Methods Ninety-eight patients with sep-sis-induced gastrointestinal dysfunction in Emergency Center of the First Affiliated Hospital of Xi'an Jiaotong University from February 2021 to February 2024 were selected as the study group,and 94 patients with sepsis but without gastrointes-tinal dysfunction who received treatment during the same period were included in the control group.Serum HSP70 and HO-1 levels were determined by enzyme-linked immunosorbent assay.The correlation between serum HSP70 and HO-1 levels and disease severity was analyzed.The influence of serum HSP70 and HO-1 on gastrointestinal dysfunction was analyzed by multivariate Logistic regression analysis.The predictive value of serum HSP70 and HO-1 levels on gastrointestinal dys-function in patients with sepsis was evaluated by receiver operating characteristic curve(ROC).Results Serum HSP70 level in the study group was higher while serum HO-1 level was lower compared to the control group(t=6.984,7.404,P＜0.001).Serum HSP70 level in grade Ⅲ-Ⅳ patients was higher than that in grade Ⅰ-Ⅱ patients while serum HO-1 level was lower(t=3.605,2.148,P＜0.05).Spearman rank correlation analysis suggested that serum HSP70 level was positively correlated with the degree of gastrointestinal dysfunction,and HO-1 level was negatively associated with gastrointestinal dysfunction de-gree(r=0.317,-0.243,P=0.002,0.017).Multivariate Logistic regression analysis indicated that high serum HSP70 level was an independent risk factor for gastrointestinal dysfunction[OR(95％CI)=1.014(1.008-1.020)],and high serum HO-1 level was a protective factor[OR(95％CI)=0.991(0.987-0.995)].The areas under the curves(AUCs)of serum HSP70 and HO-1 alone and in combination were 0.760,0.733 and 0.914,and the AUC of HSP70 combined with HO-1 was better than that of HSP70 or HO-1 alone(Z=4.799,5.822,P＜0.001).Conclusion Serum HSP70 and HO-1 levels are important indicators af-fecting the occurrence of sepsis-induced gastrointestinal dysfunction.Early determination of the above two levels can pro-vide predictive value for the risk of sepsis-induced gastrointestinal dysfunction.