溃疡性结肠炎患者病情发展中ERK1/2信号通路变化及其与肠道机会性感染的关联

崔晓婷; 芦杰; 牛昊书; 赵翠娟

doi:10.16766/j.cnki.issn.1674-4152.003700

溃疡性结肠炎患者病情发展中ERK1/2信号通路变化及其与肠道机会性感染的关联

doi: 10.16766/j.cnki.issn.1674-4152.003700

内蒙古包钢医院消化内科，内蒙古包头 014010

基金项目:

内蒙古自然科学基金项目 2020MS08024

详细信息

通讯作者:
崔晓婷，E-mail：doctorxiaotincui@sina.com.cn

中图分类号: R574.62 R393
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- 文章访问数: 42
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- 被引次数: 0
出版历程
- 收稿日期: 2023-12-11
- 网络出版日期: 2024-12-28

Changes in ERK1/2 signaling pathway in the progression of ulcerative colitis and its association with intestinal opportunistic infections

Department of Gastroenterology, Baogang Hospital of Inner Mongolia, Baotou, Inner Mongolia 014010, China

摘要

摘要: 目的观察溃疡性结肠炎(UC)患者病情发展中细胞外调节蛋白激酶(ERK)1/2信号通路变化，并分析其与UC患者并发肠道机会性感染的关联。方法选取2021年5月—2023年5月内蒙古包头市包钢医院消化内科收治的105例UC患者作为研究组，同期体检健康者50例作为对照组，比较2组ERK-1、ERK-2 mRNA转录水平。根据是否发生肠道机会性感染将105例UC患者分为感染组、未感染组并筛选危险因素，分析其对UC患者并发肠道机会性感染的预测价值。结果研究组ERK-1、ERK-2 mRNA相对表达量均高于对照组(P＜0.05)，且其变化随UC患者病情进展而升高(P＜0.05)。与未感染组比较，感染组疾病活动度重度率、血红蛋白、红细胞沉降率(ESR)水平及ERK-1 mRNA、ERK-2 mRNA相对表达量均较高(P＜0.05)，白蛋白水平较低(P＜0.05)。重度、白蛋白降低及ERK-1 mRNA、ERK-2 mRNA表达上调是影响UC患者并发肠道机会性感染的独立危险因素，ERK-1 mRNA、ERK-2 mRNA及其联合应用模型预测UC患者并发肠道机会性感染的AUC分别为0.823、0.835、0.907。结论 ERK-1、ERK-2表达水平随UC患者病情进展而升高，且其是影响UC患者发生肠道机会性感染的独立危险因素，两者联合预测UC患者并发肠道机会性感染的效能较高。
- 溃疡性结肠炎 /
- ERK1/2信号通路 /
- 肠道机会性感染
Abstract: Objective To observe the changes of extracellular regulatory protein kinase (ERK) 1/2 signaling pathway in the progression of ulcerative colitis (UC) and analyze its association with intestinal opportunistic infection in UC patients. Methods A total of 105 UC patients admitted to the gastroenterology department of Baogang Hospital of Inner Mongolia from May 2021 to May 2023 were selected as the study group, and 50 healthy subjects were selected as the control group during the same period, the mRNA transcription levels of ERK-1 and ERK-2 were compared between the two groups. According to the occurrence of intestinal opportunistic infection, 105 UC patients were divided into an infected group and an uninfected group, and the risk factors were screened to analyze the predictive value of UC patients with intestinal opportunistic infection. Results The mRNA relative expression levels of ERK-1 and ERK-2 in the study group were higher than those in the control group (P < 0.05), and their changes increased with the progression of UC patients (P < 0.05). Compared with the uninfected group, the disease activity severity rate, hemoglobin, erythrocyte sedimentation rate (ESR) levels, ERK-1 and ERK-2 mRNA transcription levels in the infected group were higher (P < 0.05), and the albumin level was lower (P < 0.05). Severity, decreased albumin and up-regulated expression of ERK-1 mRNA and ERK-2 mRNA were independent risk factors for intestinal opportunistic infections in UC patients. ROC curve results showed that the AUC of ERK-1 mRNA, ERK-2 mRNA, and their combined application model for predicting intestinal opportunistic infection in UC patients were 0.823, 0.835, and 0.907 respectively. Conclusion The expression levels of ERK-1 and ERK-2 increased with the progression of UC patients, and they were independent risk factors affecting the occurrence of intestinal opportunistic infections in UC patients, the combined expression levels of ERK-1 and ERK-2 were highly effective in predicting intestinal opportunistic infections in UC patients.
- Ulcerative colitis /
- Extracellular regulatory protein kinase1/2 signaling pathway /
- Intestinal opportunistic infection

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图 1 ERK-1、ERK-2预测UC患者并发肠道机会性感染的ROC曲线

Figure 1. ROC curve of ERK-1 and ERK-2 predicting intestinal opportunistic infection in UC patients

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表 1 对照组、研究组ERK-1、ERK-2 mRNA转录水平比较

Table 1. Comparison of mRNA transcription levels of ERK-1 and ERK-2 between the control group and the research group

组别	例数	ERK-1	ERK-2
对照组	50	0.15±0.03	0.27±0.08
研究组
轻度	35	0.30±0.08^a	0.92±0.17^a
中度	48	0.62±0.12^ab	1.29±0.22^ab
重度	22	0.98±0.19^abc	1.65±0.28^abc
F值		381.321	380.184
P值		＜0.001	＜0.001
注：与对照组比较，^aP＜0.05；与轻度组比较，^bP＜0.05；与中度组比较，^cP＜0.05。

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表 2 感染组与未感染组临床资料比较

Table 2. Comparison of clinical data between the infected group and the uninfected group

项目	感染组(n=32)	未感染组(n=73)	统计量	P值
性别[例(%)]			0.915^a	0.339
男性	22(68.75)	43(58.90)
女性	10(31.25)	30(41.10)
年龄[例(%)]			0.227^a	0.634
＜45岁	12(37.50)	31(42.47)
≥45岁	20(62.50)	42(57.53)
BMI(x±s)	21.25±2.05	21.02±1.98	0.542^b	0.589
高血压[例(%)]	10(31.25)	21(28.77)	0.066^a	0.797
糖尿病[例(%)]	5(15.63)	10(13.70)	0.067^a	0.795
高脂血症[例(%)]	8(25.00)	14(19.18)	0.455^a	0.500
疾病活动度[例(%)]
轻度	8(25.00)	27(36.98)	1.058^a	0.304
中度	12(37.50)	36(49.32)	1.251^a	0.263
重度	12(37.50)	10(13.70)	7.610^a	0.006
病变范围[例(%)]
直肠型	6(18.75)	12(16.44)	0.084^a	0.772
左半结肠型	10(31.25)	20(27.40)	0.162^a	0.687
广泛结肠型	16(50.00)	41(56.16)	0.341^a	0.559
血红蛋白(x±s，g/L)	112.25±6.25	94.92±2.15	21.114^b	0.001
白蛋白(x±s，g/L)	27.65±1.37	41.62±2.90	33.612^b	0.001
ESR(x±s，mm/h)	35.02±6.25	26.17±4.19	8.516^b	＜0.001
CRP(x±s，mg/L)	3.92±0.82	3.76±0.75	0.978^b	0.330
ERK-1 mRNA(x±s)	0.95±0.15	0.42±0.08	23.574^b	＜0.001
ERK-2 mRNA(x±s)	1.58±0.20	1.09±0.10	16.754^b	＜0.001
注: ^a为χ²值，^b为t值。

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表 3 各变量赋值情况

Table 3. Variable assignment

变量	赋值方法
肠道机会性感染	感染=1，未感染=0
重度	是=1，否=0
血红蛋白	连续变量
白蛋白	连续变量
ESR	连续变量
ERK-1 mRNA	连续变量
ERK-2 mRNA	连续变量

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表 4 影响UC患者肠道机会性感染的危险因素分析

Table 4. Risk factors affecting intestinal opportunistic infections in UC patients

变量	B	SE	Waldχ²	P值	OR值	95% CI
重度	0.594	0.267	6.589	＜0.001	1.612	1.405~1.951
白蛋白降低	0.521	0.298	6.390	0.010	1.550	1.319~1.906
ERK-1 mRNA表达上调	0.608	0.232	7.788	＜0.001	1.874	1.637~2.338
ERK-2 mRNA表达上调	0.617	0.225	7.234	＜0.001	1.864	1.658~2.215

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表 5 ERK-1、ERK-2预测UC患者并发肠道机会性感染的ROC曲线参数

Table 5. ROC curve parameters of ERK-1 and ERK-2 in predicting intestinal opportunistic infections in UC patients

项目	AUC(0.95 CI)	灵敏度(%)	特异度(%)	约登指数	准确度
ERK-1 mRNA	0.823(0.734~0.918)	86.90	80.90	0.678	0.825
ERK-2 mRNA	0.835(0.762~0.905)	84.50	74.60	0.591	0.869
联合应用模型	0.907(0.798~0.939)	90.50	81.50	0.720	0.896

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