Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, 1 Shuaifuyuan Road, Dongcheng District, Beijing, 100730, China.
BMC Pulm Med. 2021 Feb 25;21(1):66. doi: 10.1186/s12890-021-01437-2.
Mitochondrial DNA (mtDNA) is a critical activator of inflammation. Circulating mtDNA released causes lung injury in experimental models. We hypothesized that elevated plasma mtDNA levels are associated with acute lung injury (ALI) in septic patients.
We enrolled 66 patients with sepsis admitted to the Department of Critical Care Medicine of Peking Union Medical College Hospital between January 2019 and October 2019. Respiratory, hemodynamic and bedside echocardiographic parameters were recorded. Plasma mtDNA, procalcitonin, interleukin 6, and interleukin 8 levels were examined.
Plasma mtDNA levels within 24 h after admission were significantly increased in the group of septic patients with ALI [5.01 (3.38-6.64) vs 4.13 (3.20-5.07) log copies/µL, p 0.0172]. mtDNA levels were independently associated with mortality (hazard ratio, 3.2052; 95% CI 1.1608-8.8500; p 0.0253) and ALI risk (odds ratio 2.7506; 95% CI 1.1647-6.4959; p 0.0210). Patients with high mtDNA levels had worse outcomes, and post hoc tests showed significant differences in 28-day survival rates. Increased mtDNA levels were seen in patients with abdominal infection.
Increased plasma mtDNA levels within 24 h after admission were significantly associated with ALI incidence and mortality in septic patients.
线粒体 DNA（mtDNA）是炎症的关键激活物。循环中释放的 mtDNA 会导致实验模型中的肺损伤。我们假设，在脓毒症患者中，升高的血浆 mtDNA 水平与急性肺损伤（ALI）相关。
我们纳入了 2019 年 1 月至 2019 年 10 月期间收入北京协和医学院医院重症监护医学科的 66 例脓毒症患者。记录呼吸、血流动力学和床边超声心动图参数。检测血浆 mtDNA、降钙素原、白细胞介素 6 和白细胞介素 8 水平。
入院后 24 小时内，发生 ALI 的脓毒症患者的血浆 mtDNA 水平显著升高[5.01（3.38-6.64）vs 4.13（3.20-5.07）log 拷贝/µL，p=0.0172]。mtDNA 水平与死亡率独立相关（危险比，3.2052；95%CI 1.1608-8.8500；p=0.0253）和 ALI 风险（比值比，2.7506；95%CI 1.1647-6.4959；p=0.0210）。mtDNA 水平高的患者预后较差，事后检验显示 28 天生存率有显著差异。腹内感染患者的 mtDNA 水平升高。
入院后 24 小时内血浆 mtDNA 水平升高与脓毒症患者 ALI 的发生和死亡率显著相关。
