The Expression Levels of Serum eCIRP and Sestrin 2 in Sepsis-related ARDS and Their Prognostic Significance in Poor Prognosis

DENG Qing; ZHU Baofeng

doi:10.3639/j.issn.2095-3097.2025.08.017

Abstract：Objective To investigate the levels of extracellular cold-induced RNA-binding protein(eCIRP)and stress-induced protein 2(Sestrin 2)in the serum of patients with sepsis-related acute respiratory distress syndrome(ARDS),and to analyze their predictive value for poor prognosis.Methods A total of 78 patients with sepsis-related ARDS admitted to Nantong First People's Hospital from February 2022 to February 2024 were selected as the study group,and 78 healthy volunteers during the same period served as the control group.Serum eCIRP and Sestrin 2 levels were compared between the two groups and among patients with different disease severity in the study group.Based on 28-day survival,the study group was divided into a good prognosis subgroup(n=47)and a poor prognosis subgroup(n=31).Clinical data and serum eCIRP and Sestrin 2 levels were compared between these two subgroups.The correlation between serum eCIRP and Sestrin 2 levels and prognosis in sepsis-related ARDS patients was analyzed,as well as their predictive value for poor prognosis.Results Serum eCIRP and Sestrin 2 levels in the study group were(17.35±4.81)μg/L and(15.73±3.26)μg/L,respectively,significantly higher than those in the control group[(3.18±0.72)μg/L and(9.51±2.74)μg/L](P<0.05).Levels in patients with septic shock were higher than those in patients with sepsis(P<0.05).Serum eCIRP and Sestrin 2 levels showed a gradual increasing trend in patients with mild,moderate,and severe ARDS(P<0.05).Significant differences were observed between the poor and good prognosis subgroups regarding sepsis severity,ARDS severity,and Sequential Organ Failure Assessment(SOFA)score(P<0.05).Serum eCIRP and Sestrin 2 levels were higher in the poor prognosis subgroup compared to the good prognosis subgroup(P<0.05).After adjustment for sepsis severity,ARDS severity,and SOFA score,serum eCIRP and Sestrin 2 remained independent factors influencing prognosis(P<0.05).Smooth curve fitting analysis revealed linear correlations of serum eCIRP and Sestrin 2 levels with prognosis(β=0.066,95%CI:0.038-0.095;β=0.083,95%CI:0.047-0.120).The areas under the curve for predicting poor prognosis using serum eCIRP,Sestrin 2 alone,and their combination were 0.753,0.743,and 0.863,respectively.The predictive value of the combination was significantly higher than that of either marker alone(Z=2.414,P=0.028;Z=2.757,P=0.021).Conclusion Serum eCIRP and Sestrin 2 levels are elevated in patients with sepsis-related ARDS and are closely associated with disease severity.These levels show a linear correlation with patient prognosis.Detection of serum eCIRP and Sestrin 2 levels has predictive value for poor prognosis,with combined detection offering superior predictive value.