PREDICTIVE VALUE OF H3K18 LACTYLATION FOR EARLY DETECTION AND PROGNOSIS OF SEPSIS-RELATED ACUTE RESPIRATORY DISTRESS SYNDROME: A PROSPECTIVE OBSERVATIONAL CLINICAL STUDY

急性呼吸窘迫综合征 观察研究 医学 生物标志物 重症监护室 沙发评分 前瞻性队列研究 阿帕奇II 机械通风 内科学 接收机工作特性 败血症 逻辑回归 胃肠病学 生物化学 化学
作者
Xing Li,Yang Shang,Jialong Zhang,Genhua Mu,Yuxuan Duan,Zhongqian Lu,Yijun Deng
出处
期刊:Shock [Lippincott Williams & Wilkins]
卷期号:64 (2): 154-160 被引量:6
标识
DOI:10.1097/shk.0000000000002601
摘要

ABSTRACT: Background: This study aimed to investigate the predictive value of histone H3 lysine 18 lactylation (H3K18la) for the early identification and prognosis of sepsis-related acute respiratory distress syndrome (ARDS). Methods: This prospective observational study included patients with sepsis admitted to the intensive care unit (ICU) between March 2023 and September 2024. The patients were divided into two groups: the sepsis with ARDS group and the sepsis without ARDS group. Clinical data were collected within 24 h of ICU admission. Bronchoalveolar lavage fluid (BALF) samples were obtained on day 1 for all participants, and a second BALF sample was collected on day 3 from patients requiring continued mechanical ventilation. Results: In total, 91 sepsis patients were enrolled in the study: 36 with ARDS and 55 without ARDS. H3K18la levels in BALF were significantly higher in the sepsis-related ARDS group than in the non-ARDS group and the control group ( P < 0.05). Elevated H3K18la levels were positively correlated with inflammatory markers (lactate, IL-6, and TNF-α), Acute Physiology and Chronic Health Evaluation II scores, and Sequential Organ Failure Assessment scores ( P < 0.01). Logistic regression analysis revealed that H3K18la was an independent predictor of ARDS development ( P < 0.05), and ROC curve analysis revealed that H3K18la had high diagnostic accuracy (AUC = 0.804). Combining H3K18la with the Sequential Organ Failure Assessment score further improved diagnostic performance (AUC = 0.830, sensitivity = 88.9%, specificity = 67.3%). Furthermore, H3K18la levels significantly increased on day 3 in the mortality group. Conclusion: H3K18la is a promising biomarker for the early identification and prognostic prediction of sepsis-related ARDS.
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