目的 研究血浆热休克蛋白A12B（heat shock protein A12B， HSPA12B）对多器官功能障碍综合征（multiple organ dysfunction syndrome， MODS）患者预后的意义。 方法 采用前瞻性病例对照研究。纳入MODS患者30例，存活组14例，死亡组16例，并纳入全身炎症反应综合征（systemic inflammatory response syndrome， SIRS）患者30例，健康志愿者15例。记录患者的人口统计学资料、临床信息、急性生理和慢性健康评分（acute physiology and chronic health evaluation Ⅱ， APACHE Ⅱ）、MODS评分及序贯性器官衰竭评分（sequential organ failure assessment， SOFA）。通过酶联免疫吸附试验（enzyme?蛳linked immunosorbent assay， ELISA）测定诊断MODS后24 h内外周血中HSPA12B水平，探讨其与患者病情及预后的相关性。 结果 MODS患者外周血中HSPA12B水平较SIRS患者、健康志愿者显著升高（P<0.001），且死亡组患者外周血中HSPA12B的水平较存活组显著升高（P<0.05）；MODS死亡组患者较存活组患者APACHE Ⅱ评分、SOFA评分、MODS评分、机械通气时间差异有统计学意义（P<0.05），外周血中HSPA12B水平与APACHE Ⅱ评分、SOFA评分和MODS评分显著正相关。HSPA12B预测患者死亡的曲线下面积（area under the cure， AUC）为0.826（95% CI： 0.663~0.989，P<0.01），显著高于白介素（interleukin， IL）?蛳6（P<0.01）。当HSPA12B水平为1.577 μg/L时，HSPA12B预测患者死亡的敏感度为72.2%，特异度为86.8%。 结论 血浆HSPA12B水平可作为判断MODS患者预后的指标。
Ｏｂｊｅｃｔｉｖｅ The aim of this study was to explore the role of heat shock protein A12B（HSPA12B） as a potential prognosis biomarker for multiple organ dysfunction syndrome（MODS）. Methods The study involved 30 patients with MODS， including non-survivors（n=16） and survivors（n=14）. Thirty patients with systemic inflammatory response syndrome（SIRS） and 15 healthy controls to evaluate the prognostic value of HSPA12B. The levels of plasma HSPA12B and interleukin（IL）-6 were measured by enzyme linked immunosorbent assay （ELISA）. Results The level of plasma HSPA12B was significantly higher in patients with MODS than that in other two groups（P<0.001）. There is no differences in HSPA12B levels between SIRS patients and healthy volunteers（P=0.647）. Level of HSPA12B in non-survivors was significantly higher than that in survivors（P<0.05）. Acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ）score， MODS score， Sequential organ failure assessment（SOFA） score， and length of mechanical ventilation in non-survivors were significantly higher than surviors. For prognostic value of HSPA12B， it has a area under the cure（AUC）of 0.826（95% CI： 0.663-0.989， P<0.01）， significantly higher than IL-6. Conclusions Increased plasma HSPA12B within 24 h after onset of MODS can be considered as a potential prognostic biomarker in patients.
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