血浆中的线粒体DNA与危重症患者的长期身体恢复：一项观察性研究
Mitochondrial DNA in plasma and long-term physical recovery of critically ill patients: an observational study.
作者信息
Galvis-Pedraza Maryory, Beumeler Lise F E, van der Slikke Elisabeth C, Boerma E Christiaan, van Zutphen Tim
机构信息
Department of Sustainable Health, Faculty Campus Fryslân, University of Groningen, Leeuwarden, The Netherlands.
Department of Intensive Care, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
出版信息
Intensive Care Med Exp. 2024 Nov 6;12(1):99. doi: 10.1186/s40635-024-00690-z.
BACKGROUND
Post-intensive care syndrome (PICS) poses a notable public health concern, with survivors of critical illness experiencing long-term physical, psychological, and cognitive challenges. Mitochondrial dysfunction has gained attention for its potential involvement in PICS. However, the long-term impact of mitochondrial status on patient recovery remains uncertain. A single-centre retrospective analysis was conducted in Leeuwarden, the Netherlands, between May and November 2019, within a mixed ICU survivor cohort. Patients were assessed for mitochondrial markers (mtDNA damage represented by the presence of mtDNA fragmentation and mitochondrial DNA levels evaluated by the ratio of mtDNA and nuclear DNA), clinical factors, and long-term outcomes measured by the physical functioning (PF) domain of health-related quality of life.
RESULTS
A total of 43 patients were included in this study divided into recovery and non-recovery groups based on age-adjusted PF scores at 12 months post-ICU. Nineteen patients scored below these thresholds. No significant differences in mitochondrial markers between groups were identified. Furthermore, no significant correlations were found between mtDNA levels and mtDNA damage at baseline and 12 months with PF scores. However, mtDNA levels decreased over time in the recovery (p-value < < 0.01) and non-recovery groups (p-value < 0.01).
CONCLUSION
No significant correlation was found between mitochondrial markers and physical functioning scores. This study underscores the multifactorial nature of PICS and the need for a comprehensive understanding of its metabolic and cellular components. While mitochondrial markers may play a role in PICS, they operate within a framework influenced by various factors. This exploratory study serves as a foundation for future investigations aimed at developing targeted interventions to enhance the quality of life for ICU survivors grappling with PICS.
背景
重症监护后综合征（PICS）是一个显著的公共卫生问题，危重症幸存者面临长期的身体、心理和认知挑战。线粒体功能障碍因其可能参与PICS而受到关注。然而，线粒体状态对患者康复的长期影响仍不确定。2019年5月至11月在荷兰吕伐登进行了一项单中心回顾性分析，纳入了混合重症监护病房幸存者队列。对患者进行线粒体标志物（以线粒体DNA片段化的存在表示的线粒体DNA损伤以及通过线粒体DNA与核DNA的比率评估的线粒体DNA水平）、临床因素以及通过健康相关生活质量的身体功能（PF）领域衡量的长期结局评估。
结果
本研究共纳入43例患者，根据重症监护病房出院后12个月的年龄调整PF评分分为康复组和未康复组。19例患者得分低于这些阈值。未发现两组之间线粒体标志物有显著差异。此外，在基线和12个月时，线粒体DNA水平与线粒体DNA损伤与PF评分之间未发现显著相关性。然而，康复组（p值<0.01）和未康复组（p值<0.01）中线粒体DNA水平均随时间下降。
结论
线粒体标志物与身体功能评分之间未发现显著相关性。本研究强调了PICS的多因素性质以及全面了解其代谢和细胞成分的必要性。虽然线粒体标志物可能在PICS中起作用，但它们在受多种因素影响的框架内发挥作用。这项探索性研究为未来旨在开发针对性干预措施以提高患有PICS的重症监护病房幸存者生活质量的研究奠定了基础。
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