摘要
目的研究血清白细胞介素(interleukin,IL)-6、沉默信息调节因子(silent information regulator,SIRT)-1与急诊科老年患者衰弱的相关性。方法本研究为横断面研究,收集2022年1月至12月于北京博爱医院急诊科治疗的60岁及以上患者。入院后24 h内检测血常规、生化、IL-6水平;同时采集空腹静脉血2 mL,离心后血清放置-80℃储存,采用酶联免疫吸附测定法检测SIRT-1水平。72 h内进行营养风险筛查2002评分,采用Barthel指数进行日常生活能力评定,测量握力。根据Fried衰弱表型(frailty phenotype,FP)评分,将患者分为衰弱与无衰弱组。比较衰弱与无衰弱组间临床资料及实验室指标的差异。采用多因素Logistic回归模型分析血清IL-6、SIRT-1与衰弱的相关性;采用受试者工作特征(receiver operating characteristic,ROC)曲线评价血清IL-6、SIRT-1对衰弱的预测能力。结果本研究纳入患者316例,依据Fried FP标准,分为衰弱组(n=156)和无衰弱组(n=160)。单因素分析示,衰弱组血清IL-6[33.3(13.0,69.2)ng/L vs.20.0(9.2,41.3)ng/L,P=0.001]、SIRT-1[(9.98±1.23)μg/L vs.(8.98±1.65)μg/L,P<0.001]均高于无衰弱组。Logistic回归分析显示,调整年龄、性别、身体质量指数、Barthel指数、握力后,血清IL-6(OR=1.006,95%CI:1.001~1.011,P=0.036)和SIRT-1(OR=1.838,95%CI:1.475~2.290,P<0.001)与衰弱独立相关。IL-6预测衰弱的ROC曲线下面积(area under the ROC curve,AUC)为0.671(95%CI:0.604~0.738,P<0.001),截点值为33.8 ng/L;SIRT-1预测衰弱的AUC为0.736(95%CI:0.674~0.799,P<0.001),截点值为9.13μg/L;二者联合模型的AUC为0.765(95%CI:0.707~0.823,P<0.001),敏感度为0.776,特异度为0.726,其预测效能优于单独应用IL-6(Z=2.119,P=0.034)。结论血清IL-6和SIRT-1可作为急诊科老年患者衰弱的独立预测因子。
Objective To investigate the association between serum interleukin(IL)-6 and silent information regulator(SIRT)-1 and frailty in elderly patients in the emergency department.Methods This was a cross-sectional study.Patients aged 60 years and above treated in the emergency department of Beijing Bo'Ai Hospital from January to December 2022 were collected.Blood routine,biochemical indicators,and serum IL-6 were detected within 24 h after enrollment.At the same time,fasting venous blood 2 mL was collected and the serum was stored at minus 80℃after centrifugation.The level of SIRT-1 was detected by enzyme-linked immunosorbent assay.Nutritional risk screening 2002 was performed within 72 h,Barthel index was used to assess the ability of daily living and grip strength was measured.The patients were divided into frailty and non-frailty groups according to Fried frailty phenotype(FP).The differences of clinical data and laboratory indicators were compared between the two groups.Multivariable logistic regression model was used to analyze the association between serum IL-6,SIRT-1 and frailty.The predictive ability of serum IL-6 and SIRT-1 for frailty was evaluated by the receiver operating characteristic(ROC)curve.Results A total of 316 elderly patients in the emergency department were included in this study and divided into frailty group(n=156)and non-frailty group(n=160)according to Fried FP criteria.Univariate analysis showed that serum IL-6[33.3(13.0,69.2)ng/L vs.20.0(9.2,41.3)ng/L,P=0.001]and SIRT-1[(9.98±1.23)μg/L vs.(8.98±1.65)μg/L,P<0.001]of patients in the frailty group were higher than those in the non-frailty group.Multivariable logistic regression analysis showed that serum IL-6(OR=1.006,95%CI:1.001-1.011,P=0.036)and SIRT-1(OR=1.838,95%CI:1.475-2.290,P<0.001)were independently associated with frailty after adjusting for age,sex,body mass index,Barthel index and grip strength.The area under the curve(AUC)of serum IL-6 for predicting frailty was 0.671(95%CI:0.604-0.738,P<0.001),the predictive cut-off point was 33.8 ng/L.The AUC of SIRT-1 for predicting frailty was 0.736(95%CI:0.674-0.799,P<0.001),the predictive cut-off point was 9.13μg/L.The AUC of the model of IL-6 combined with SIRT-1 was 0.765(95%CI:0.707-0.823,P<0.001),the sensitivity and specificity were 0.776 and 0.726,respectively,and its predictive efficacy was superior to that of IL-6 alone(Z=2.119,P=0.034).Conclusion Serum IL-6 and SIRT-1 are independent predictors of frailty in elderly patients in the emergency department.
作者
刘慧珍
王娜
商娜
李俊玉
刘小蒙
郭树彬
腾飞
Liu Huizhen;Wang Na;Shang Na;Li Junyu;Liu Xiaomeng;Guo Shubin;Teng Fei(Department of Emergency Medicine,Beijing Bo'Ai Hospital,China Rehabilitation Research Center,Capital Medical University School of Rehabilitation Medicine,Beijing 100068,China;Emergency Medicine Center,Beijing ChaoYang Hospital,Capital Medical University,Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation,Beijing 100020,China)
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2024年第5期677-682,共6页
Chinese Journal of Emergency Medicine
基金
中国康复研究中心科研项目(2023ZX-23)
心肺脑复苏北京市重点实验室开放课题(2020XFN-KFKT-01)。
