Lactate dehydrogenase

乳酸脱氢酶
  • 文章类型: Journal Article
    硝基氧是由硝酰基组成的稳定基团,>N-O•,它携带一个不成对的电子。该基团负责这些化合物的顺磁性和抗氧化性质。最近的一项研究评估了硝基氧的吡咯烷和吡咯啉衍生物对人红细胞(RBC)抗氧化系统的影响。结果表明,硝基氧引起细胞中超氧化物歧化酶(SOD)活性和高铁血红蛋白(MetHb)水平的增加(在吡咯啉衍生物中),但对过氧化氢酶和乳酸脱氢酶的活性没有影响。硝基氧化物还降低了细胞中抗坏血酸(AA)的浓度,但不会引起蛋白质或脂质的任何氧化。有趣的是,硝基氧引起质膜和溶血产物中硫醇的增加。然而,该研究还显示,氮氧化物可能具有促氧化特性。AA浓度的下降以及MetHb水平和SOD活性的增加可能表明红细胞中氮氧化物的促氧化特性。
    Nitroxides are stable radicals consisting of a nitroxyl group, >N-O•, which carries an unpaired electron. This group is responsible for the paramagnetic and antioxidant properties of these compounds. A recent study evaluated the effects of pyrrolidine and pyrroline derivatives of nitroxides on the antioxidant system of human red blood cells (RBCs). It showed that nitroxides caused an increase in the activity of superoxide dismutase (SOD) and the level of methemoglobin (MetHb) in cells (in pyrroline derivatives) but had no effect on the activity of catalase and lactate dehydrogenase. Nitroxides also reduced the concentration of ascorbic acid (AA) in cells but did not cause any oxidation of proteins or lipids. Interestingly, nitroxides initiated an increase in thiols in the plasma membranes and hemolysate. However, the study also revealed that nitroxides may have pro-oxidant properties. The drop in the AA concentration and the increase in the MetHb level and in SOD activity may indicate the pro-oxidant properties of nitroxides in red blood cells.
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  • 文章类型: Journal Article
    探讨前列腺癌骨转移进展为去势抵抗的预测因素及预测模型构建
    286例前列腺癌骨转移患者的临床资料,最初接受内分泌治疗,并收集进展为转移性去势耐药前列腺癌(mCRPC)。通过比较各种因素在去势抵抗性前列腺癌(CRPC)发生快、慢不同人群之间的差异。采用Kaplan-Meier生存分析和COX多因素风险比例回归模型比较不同组患者进展至CRPC时间的差异。采用COX多因素风险比例回归模型评价候选因素对进展至CRPC时间的影响,建立预测模型。然后使用受试者工作特性(ROC)曲线和决策曲线分析(DCA)测试模型的准确性。
    286名mCRPC患者进展为CRPC的中位时间为17(9.5-28.0)个月。多因素分析显示,PSA最低值(PSA最低点),PSA下降到最低值的时间(timePSA),和BM的数量,LDH是CRPC快速进展的独立危险因素。根据上述四个独立风险因素,建立了预测模型,在训练和验证队列中,最佳预测模型是曲线下面积(AUC)为0.946[95%CI:0.901-0.991]和0.927[95%CI:0.864-0.990]的随机森林,分别。
    内分泌治疗后,PSA最低点,timePSA,BM的数量,和LDH是前列腺癌骨转移患者快速进展为mCRPC的主要危险因素。建立CRPC预测模型有助于早期临床干预决策。
    UNASSIGNED: To explore the predictive factors and predictive model construction for the progression of prostate cancer bone metastasis to castration resistance.
    UNASSIGNED: Clinical data of 286 patients diagnosed with prostate cancer with bone metastasis, initially treated with endocrine therapy, and progressing to metastatic castration resistant prostate cancer (mCRPC) were collected. By comparing the differences in various factors between different groups with fast and slow occurrence of castration-resistant prostate cancer (CRPC). Kaplan-Meier survival analysis and COX multivariate risk proportional regression model were used to compare the differences in the time to progression to CRPC in different groups. The COX multivariate risk proportional regression model was used to evaluate the impact of candidate factors on the time to progression to CRPC and establish a predictive model. The accuracy of the model was then tested using receiver operating characteristic (ROC) curves and decision curve analysis (DCA).
    UNASSIGNED: The median time for 286 mCRPC patients to progress to CRPC was 17 (9.5-28.0) months. Multivariate analysis showed that the lowest value of PSA (PSA nadir), the time when PSA dropped to its lowest value (timePSA), and the number of BM, and LDH were independent risk factors for rapid progression to CRPC. Based on the four independent risk factors mentioned above, a prediction model was established, with the optimal prediction model being a random forest with area under curve (AUC) of 0.946[95% CI: 0.901-0.991] and 0.927[95% CI: 0.864-0.990] in the training and validation cohort, respectively.
    UNASSIGNED: After endocrine therapy, the PSA nadir, timePSA, the number of BM, and LDH are the main risk factors for rapid progression to mCRPC in patients with prostate cancer bone metastases. Establishing a CRPC prediction model is helpful for early clinical intervention decision-making.
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  • 文章类型: Journal Article
    2-羟基戊二酸(2HG)是一种可促进肿瘤进展的代谢产物。两种对映异构体形式,L-2HG和D-2HG,从前体α-酮戊二酸(αKG)开始的独立途径产生。在酸性和/或低氧条件下,通过苹果酸脱氢酶(MDH)和乳酸脱氢酶(LDH)的混杂活性产生L-2HG。D-2HG经常通过编码异柠檬酸脱氢酶的两种同工型(IDH1和IDH2)的基因中的功能获得性突变而积累。同源代谢物修复酶,L-和D-2-羟基戊二酸脱氢酶,氧化对映异构体,并在突变时引起异常高的2HG积累和疾病。两种代谢物水平的升高都会影响氧化还原稳态,新陈代谢,和免疫系统功能。此外,代谢产物抑制几种α-酮戊二酸依赖性双加氧酶,导致表观遗传变化,如DNA和组蛋白超甲基化以及DNA修复缺陷。L-2HG,和D-2HG在某些情况下,抑制缺氧诱导因子(HIF1α)的降解,改变基因表达以适应缺氧条件的转录因子,有利于肿瘤发生。罕见疾病2-羟基戊二酸尿症(2HGA)患者的2HG水平极高,有神经毒性,导致发育迟缓和大脑异常。D-2HG还对胶原蛋白产生和NADPH池具有特定作用。最近,D-2HG已成为新的化疗药物的目标,旨在破坏IDH1和IDH2突变体的功能获得。导致几种癌症的成功临床试验。
    2-Hydroxyglutarate (2HG) is an oncometabolite that can contribute to tumor progression. Two enantiomer forms, L-2HG and D-2HG, arise from independent pathways starting from the precursor α-ketoglutarate (αKG). L-2HG production occurs through the promiscuous activities of malate dehydrogenase (MDH) and lactate dehydrogenase (LDH) under acidic and/or hypoxic conditions. D-2HG frequently accumulates by gain-of-function mutations in the genes encoding two isoforms of isocitrate dehydrogenase (IDH1 and IDH2). Cognate metabolite repair enzymes, L- and D-2-hydroxyglutarate dehydrogenases, oxidize the enantiomers and cause abnormally high 2HG accumulation and disease when mutated. Elevated levels of either oncometabolite affect redox homeostasis, metabolism, and immune system functioning. Moreover, the oncometabolites inhibit several α-ketoglutarate-dependent dioxygenases resulting in epigenetic changes such as DNA and histone hypermethylation as well as deficiencies in DNA repair. L-2HG, and D-2HG in some cases, inhibit degradation of hypoxia-inducible factor (HIF1α), a transcription factor that alters gene expression to adapt to hypoxic conditions, favoring tumorigenesis. Patients with the rare disease 2-hydroxyglutaric aciduria (2HGA) have exceedingly high levels of 2HG, which is neurotoxic, causing developmental delays and brain abnormalities. D-2HG also has specific effects on collagen production and NADPH pools. Recently, D-2HG has been targeted in new chemotherapies aimed at disrupting the gain-of-function IDH1 and IDH2 mutants, resulting in successful clinical trials for several cancers.
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  • 文章类型: Journal Article
    在这里,我们报告了冲击波(SW)对成年大鼠海马祖细胞(AHPC)神经球(NSs)的影响的评估,它们被用作体外大脑模型,增强我们对创伤性脑损伤(TBI)机制的理解。通过使用培养皿和新的微芯片实现了评估。微芯片允许在SW冲击下从细胞培养室内培养的大脑模型释放的化学物质通过内置的扩散屏障扩散到相邻传感器室中的纳米传感器,用于防止细胞进入传感器室,从而减轻传感器表面的生物污染问题。实验表明,SW对生存能力的负面影响,扩散,和NS内细胞的分化。进行qPCR基因表达分析,似乎证实了一些免疫细胞化学(ICC)结果。最后,我们证明,微芯片可用于监测受SW影响的AHPC-NS释放的乳酸脱氢酶(LDH)。不出所料,当AHPC-NS受到SW撞击时,LDH水平发生变化,验证该芯片可用于通过监测LDH水平评估AHPC-NS的损伤程度。一起来看,这些结果表明,使用该芯片更好地了解SW影响和体外脑模型之间的相互作用的可行性,为在芯片上建立体外TBI模型铺平了道路。
    Herein we report the assessment of the effects of shockwave (SW) impacts on adult rat hippocampal progenitor cell (AHPC) neurospheres (NSs), which are used as in vitro brain models, for enhancing our understanding of the mechanisms of traumatic brain injury (TBI). The assessment has been achieved by using culture dishes and a new microchip. The microchip allows the chemicals released from the brain models cultured inside the cell culture chamber under SW impacts to diffuse to the nanosensors in adjacent sensor chambers through built-in diffusion barriers, which are used to prevent the cells from entering the sensor chambers, thereby mitigating the biofouling issues of the sensor surface. Experiments showed the negative impact of the SW on the viability, proliferation, and differentiation of the cells within the NSs. A qPCR gene expression analysis was performed and appeared to confirm some of the immunocytochemistry (ICC) results. Finally, we demonstrated that the microchip can be used to monitor lactate dehydrogenase (LDH) released from the AHPC-NSs subjected to SW impacts. As expected, LDH levels changed when AHPC-NSs were injured by SW impacts, verifying this chip can be used for assessing the degrees of injuries to AHPC-NSs by monitoring LDH levels. Taken together, these results suggest the feasibility of using the chip to better understand the interactions between SW impacts and in vitro brain models, paving the way for potentially establishing in vitro TBI models on a chip.
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  • 文章类型: Journal Article
    背景:没有证据确定乳酸脱氢酶与白蛋白比值(LAR)与脓毒症相关的急性肾损伤(SAKI)的发展之间的关联。我们旨在研究LAR对脓毒症患者SAKI的预测影响。
    方法:纳入来自重症监护医学信息集市IV(MIMICIV)数据库的4,087例脓毒症患者。使用Logistic回归分析来确定LAR与发生SAKI的风险之间的关联。并使用受限三次样条(RCS)可视化关系。采用ROC曲线分析评价LAR的临床预测价值。亚组分析用于搜索交互因素。
    结果:SAKI组LAR水平明显升高(p<0.001)。LAR与发生SAKI的风险之间存在正线性相关(非线性p=0.867)。Logistic回归分析显示LAR对SAKI的发展具有独立的预测价值。LAR具有中等临床价值,AUC为0.644。慢性肾脏病(CKD)被确定为独立的相互作用因素。LAR对SAKI发展的预测价值在有CKD病史的人群中消失,但在没有CKD的人群中仍然存在。
    结论:脓毒症诊断前后12hLAR升高是脓毒症患者发生SAKI的独立危险因素。慢性合并症,尤其是CKD的历史,当使用LAR预测脓毒症患者AKI的发展时,应该考虑这些因素。
    BACKGROUND: There is no evidence to determine the association between the lactate dehydrogenase to albumin ratio (LAR) and the development of sepsis-associated acute kidney injury (SAKI). We aimed to investigate the predictive impact of LAR for SAKI in patients with sepsis.
    METHODS: A total of 4,087 patients with sepsis from the Medical Information Mart for Intensive Care IV (MIMIC IV) database were included. Logistic regression analysis was used to identify the association between LAR and the risk of developing SAKI, and the relationship was visualized using restricted cubic spline (RCS). The clinical predictive value of LAR was evaluated by ROC curve analysis. Subgroup analysis was used to search for interactive factors.
    RESULTS: The LAR level was markedly increased in the SAKI group (p < 0.001). There was a positive linear association between LAR and the risk of developing SAKI (p for nonlinearity = 0.867). Logistic regression analysis showed an independent predictive value of LAR for developing SAKI. The LAR had moderate clinical value, with an AUC of 0.644. Chronic kidney disease (CKD) was identified as an independent interactive factor. The predictive value of LAR for the development of SAKI disappeared in those with a history of CKD but remained in those without CKD.
    CONCLUSIONS: Elevated LAR 12 h before and after the diagnosis of sepsis is an independent risk factor for the development of SAKI in patients with sepsis. Chronic comorbidities, especially the history of CKD, should be taken into account when using LAR to predict the development of AKI in patients with sepsis.
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  • 文章类型: Journal Article
    目的:本研究探讨了将血清乳酸脱氢酶(LDH)与多变量模型相结合评估原发性鼻咽癌(NPC)短期预后的临床意义。EB病毒(EBV)定量是NPC病例的关键预后指标,但并非所有NPC患者EBV检测阳性。此外,由于EBV-DNA定量的高成本,其广泛采用仍然具有挑战性。因此,必须纳入其他方便且具有成本效益的预后标志物,以全面评估患者的预后.
    方法:回顾性分析2018年1月至2022年3月广州医科大学附属清远医院收治的203例新诊断鼻咽癌患者。数据集包括个人信息和临床数据,治疗方案遵循CSCO指南。功效评估基于RECIST1.1标准,并在诱导化疗后以及放疗后一周和三个月进行。
    结果:在放疗后1周(P=0.03)和放疗后3个月(P<0.01),基线血清LDH水平与治疗效果之间出现显著的相关性。此外,结合年龄的预后模型(P=0.010),LDH(P<0.001),C反应蛋白(P=0.010),和碱性磷酸酶(P=0.005)显示出稳健的预测准确性和临床适用性。
    结论:这项研究证实了基线血清LDH水平与NPC结局之间的显著相关性。此外,我们介绍了一个精致的预后模型,该模型有望为个性化治疗策略提供信息,从而促进NPC的诊断。
    OBJECTIVE: This investigation explores the clinical significance of integrating serum lactate dehydrogenase (LDH) with a multivariate model for assessing the short-term prognosis of primary nasopharyngeal carcinoma (NPC). Epstein-Barr virus (EBV) quantification is a crucial prognostic indicator in NPC cases, but not all patients with NPC test positive for EBV. Furthermore, widespread adoption of EBV-DNA quantification remains challenging due to its high cost. Consequently, it is imperative to incorporate additional convenient and cost-effective prognostic markers to comprehensively evaluate patient outcomes.
    METHODS: This retrospective analysis included 203 newly diagnosed NPC cases treated at the Affiliated Qingyuan Hospital of Guangzhou Medical University between January 2018 and March 2022. The dataset included personal information and clinical data, and the treatment protocols followed the CSCO guidelines. Efficacy assessments were based on the RECIST 1.1 criteria and were conducted after induction chemotherapy and one week and three months after radiotherapy.
    RESULTS: A noteworthy correlation emerged between baseline serum LDH levels and treatment efficacy at one week after radiotherapy (P = 0.03) and at three months after radiotherapy (P < 0.01). Additionally, a prognostic model that incorporates age (P = 0.010), LDH (P < 0.001), C-reactive protein (P = 0.010), and alkaline phosphatase (P = 0.005) demonstrated robust predictive accuracy and clinical applicability.
    CONCLUSIONS: This investigation substantiates the significant correlation between baseline serum LDH levels and NPC outcomes. Furthermore, we introduce a refined prognostic model that holds promise for informing personalized treatment strategies, thereby contributing to the advancement of the diagnosis of NPC.
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  • 文章类型: Journal Article
    诺氏疟原虫是引起人类感染的疟原虫中唯一引起人畜共患疾病的疟原虫。由于其24小时内的无性生长周期短,因此是致命的。乳酸脱氢酶(LDH),一种催化糖酵解最后一步的酶,是诊断疟原虫感染的生物标志物。寄生虫.因此,本研究的目的是利用细菌表达系统有效地生产诺氏疟原虫LDH(PkLDH)的可溶性形式,用于研究诺氏疟原虫引起的疟疾。通过将PkLDH基因插入pET-21a()表达载体中,构建了重组pET-21a()-PkLDH质粒。随后,将重组质粒插入表达蛋白质的大肠杆菌Rosetta(DE3)菌株中,并使用该菌株建立了PkLDH蛋白过表达的最佳条件。我们从Rosetta(DE3)菌株中获得了52.0mg/LPkLDH的产量,并通过实验确认了483.9U/mg的活性。这种高效PkLDH生产的方法可用于开发诊断方法和药物候选物,以区分由诺氏疟原虫引起的疟疾。
    Plasmodium knowlesi is the only Plasmodium that causes zoonotic disease among the Plasmodium that cause infection in humans. It is fatal due to its short asexual growth cycle within 24 h. Lactate dehydrogenase (LDH), an enzyme that catalyzes the final step of glycolysis, is a biomarker for diagnosing infection by Plasmodium spp. parasite. Therefore, this study aimed to efficiently produce the soluble form of P. knowlesi LDH (PkLDH) using a bacterial expression system for studying malaria caused by P. knowlesi. Recombinant pET-21a(+)-PkLDH plasmid was constructed by inserting the PkLDH gene into a pET-21a(+) expression vector. Subsequently, the recombinant plasmid was inserted into the protein-expressing Escherichia coli Rosetta(DE3) strain, and the optimal conditions for overexpression of the PkLDH protein were established using this strain. We obtained a yield of 52.0 mg/L PkLDH from the Rosetta(DE3) strain and confirmed an activity of 483.9 U/mg through experiments. This methodology for high-efficiency PkLDH production can be utilized for the development of diagnostic methods and drug candidates for distinguishing malaria caused by P. knowlesi.
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  • 文章类型: Case Reports
    一只3岁的雄性绝育家养短毛猫,表现出嗜睡,缺氧,和不明原因的发热。使用BeckmanCoulterAU480的生化分析显示肌酸激酶和天冬氨酸氨基转移酶显著增加,表明严重的肌肉损伤,尿液分析中并发推定性肌红蛋白尿症。一个被标记的,记录了测量的碳酸氢盐和由此产生的负阴离子间隙的非生理性增加;然而,通过即时血气分析仪获得的计算碳酸氢盐在正常范围内.怀疑由于乳酸脱氢酶干扰而导致的实验室错误,并得到随后生化测试结果的支持。在马的横纹肌溶解症的情况下,碳酸氢盐的人工增加已被证明。奶牛,和一只鸟。然而,据作者所知,这是第一个报告,证明这种虚假的变化在一只猫。
    A 3-year-old male neutered domestic shorthair cat presented with lethargy, hyporexia, and pyrexia of unknown origin. Biochemical analysis using a Beckman Coulter AU480 demonstrated marked increases in creatine kinase and aspartate aminotransferase, indicative of severe muscle injury, with concurrent presumptive myoglobinuria on urinalysis. A marked, non-physiologic increase in measured bicarbonate and resultant negative anion gap was documented; however, calculated bicarbonate obtained via a point-of-care blood gas analyzer was within normal limits. Laboratory error due to interference by lactate dehydrogenase was suspected and supported by the results of subsequent biochemical testing. Artifactual increases in bicarbonate have been documented in cases of rhabdomyolysis in horses, cows, and a bird. However, to the best of the authors\' knowledge, this is the first report to demonstrate this spurious change in a cat.
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  • 文章类型: Journal Article
    在这里,我们研究了基于氯化磷的低共熔溶剂对T4基因型致病性棘阿米巴的抗阿米巴活性。低共熔溶剂是由两种或三种物质组成的离子流体,能够自缔合形成熔点低于每种物质的低共熔混合物。在这项研究中,配制了三种不同的疏水性深共晶溶剂,采用氯化三己基十四烷基鳞作为氢键受体和阿司匹林,十二烷酸,和4-叔丁基苯甲酸作为氢键供体。随后,所有三种深共晶溶剂,表示为DES1、DES2、DES3公式,接受了包括杀阿米巴在内的调查,附着力,excystation,细胞毒性,和细胞致病性测定。研究结果表明,DES2是最有效的抗阿米巴剂,在30°C下24小时内对变形虫的消除率为94%。粘附实验表明,低共熔溶剂阻碍了变形虫对人脑内皮细胞的粘附,DES2表现出88%的粘附性降低。值得注意的是,DES3表现出显著的抗脱落性能,防止94%的囊肿恢复为滋养体。在细胞致病性实验中,低共熔溶剂制剂和单独的十二烷酸减少了变形虫诱导的人脑内皮细胞死亡,DES2显示出最高的效果。乳酸脱氢酶测定显示测试的低共熔溶剂的细胞毒性最小,除了氯化三己基十四烷基鳞,表现出35%的内皮细胞损伤。这些发现强调了特定的深共晶溶剂在对抗致病性棘阿米巴中的潜力,为针对自由生活的变形虫的进一步研究和开发提供了有希望的途径。
    Herein, we investigated the anti-amoebic activity of phosphonium-chloride-based deep eutectic solvents against pathogenic Acanthamoeba castellanii of the T4 genotype. Deep eutectic solvents are ionic fluids composed of two or three substances, capable of self-association to form a eutectic mixture with a melting point lower than each substance. In this study, three distinct hydrophobic deep eutectic solvents were formulated, employing trihexyltetradecylphosphonium chloride as the hydrogen bond acceptor and aspirin, dodecanoic acid, and 4-tert-butylbenzoic acid as the hydrogen bond donors. Subsequently, all three deep eutectic solvents, denoted as DES1, DES2, DES3 formulations, underwent investigations comprising amoebicidal, adhesion, excystation, cytotoxicity, and cytopathogenicity assays. The findings revealed that DES2 was the most potent anti-amoebic agent, with a 94% elimination rate against the amoebae within 24 h at 30 °C. Adhesion assays revealed that deep eutectic solvents hindered amoebae adhesion to human brain endothelial cells, with DES2 exhibiting 88% reduction of adhesion. Notably, DES3 exhibited remarkable anti-excystation properties, preventing 94% of cysts from reverting to trophozoites. In cytopathogenicity experiments, deep eutectic solvent formulations and dodecanoic acid alone reduced amoebae-induced human brain endothelial cell death, with DES2 showing the highest effects. Lactate dehydrogenase assays revealed the minimal cytotoxicity of the tested deep eutectic solvents, with the exception of trihexyltetradecylphosphonium chloride, which exhibited 35% endothelial cell damage. These findings underscore the potential of specific deep eutectic solvents in combating pathogenic Acanthamoeba, presenting promising avenues for further research and development against free-living amoebae.
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  • 文章类型: Journal Article
    背景:我们旨在观察自主循环(ROSC)恢复后心脏骤停患者葡萄糖代谢重编程相关参数的动态变化及其预测神经系统预后和全因死亡率的能力。
    方法:选择2017年8月1日至2021年5月30日于大连医科大学附属第一医院急诊或心脏重症监护病房收治的ROSC术后心脏骤停成人患者。根据28天生存率,将患者分为非生存组(n=82)和生存组(n=38).选择年龄和性别相似的健康成年志愿者(n=40)作为对照。血清葡萄糖代谢重编程相关参数(乳酸脱氢酶[LDH],乳酸和丙酮酸),在ROSC后第1,3和7天检测神经元特异性烯醇化酶(NSE)和白细胞介素6(IL-6).计算急性生理学和慢性健康评估II(APACHEII)评分和序贯器官衰竭评估(SOFA)评分。在ROSC后第28天记录脑性能分类(CPC)评分。
    结果:在ROSC之后,血清LDH(607.0U/Lvs.286.5U/L),乳酸(5.0mmol/Lvs.2.0mmol/L),丙酮酸盐(178.0μmol/Lvs.70.9μmol/L),和乳酸/丙酮酸比率(34.1vs.22.1)显着增加,非幸存者比入院时幸存者高(均P<0.05)。此外,血清LDH,丙酮酸,IL-6,APACHEII评分,ROSC术后第1、3和7天的SOFA评分与28天神经功能不良预后和28天全因死亡率显著相关(均P<0.05)。ROSC后第1天的血清LDH浓度的受试者工作特征曲线下面积(AUC)为0.904[95%置信区间[95%CI]:0.851-0.957]),预测28天神经系统预后的特异性为96.8%,AUC为0.950(95%CI:0.911-0.989),预测28天全因死亡率的特异性为94.7%,在测试的葡萄糖代谢重编程相关参数中,这是最高的。
    结论:ROSC后与葡萄糖代谢重编程相关的血清参数显著升高。血清LDH和丙酮酸水平升高,乳酸/丙酮酸比值可能与ROSC后28天神经系统预后不良和全因死亡率相关,并且在第一周LDH的预测功效优于其他。
    BACKGROUND: We aimed to observe the dynamic changes in glucose metabolic reprogramming-related parameters and their ability to predict neurological prognosis and all-cause mortality in cardiac arrest patients after the restoration of spontaneous circulation (ROSC).
    METHODS: Adult cardiac arrest patients after ROSC who were admitted to the emergency or cardiac intensive care unit of the First Affiliated Hospital of Dalian Medical University from August 1, 2017, to May 30, 2021, were enrolled. According to 28-day survival, the patients were divided into a non-survival group (n=82) and a survival group (n=38). Healthy adult volunteers (n=40) of similar ages and sexes were selected as controls. The serum levels of glucose metabolic reprogramming-related parameters (lactate dehydrogenase [LDH], lactate and pyruvate), neuron-specific enolase (NSE) and interleukin 6 (IL-6) were measured on days 1, 3, and 7 after ROSC. The Acute Physiology and Chronic Health Evaluation II (APACHE II) score and Sequential Organ Failure Assessment (SOFA) score were calculated. The Cerebral Performance Category (CPC) score was recorded on day 28 after ROSC.
    RESULTS: Following ROSC, the serum LDH (607.0 U/L vs. 286.5 U/L), lactate (5.0 mmol/L vs. 2.0 mmol/L), pyruvate (178.0 μmol/L vs. 70.9 μmol/L), and lactate/pyruvate ratio (34.1 vs. 22.1) significantly increased and were higher in the non-survivors than in the survivors on admission (all P<0.05). Moreover, the serum LDH, pyruvate, IL-6, APACHE II score, and SOFA score on days 1, 3 and 7 after ROSC were significantly associated with 28-day poor neurological prognosis and 28-day all-cause mortality (all P<0.05). The serum LDH concentration on day 1 after ROSC had an area under the receiver operating characteristic curve (AUC) of 0.904 [95% confidence interval [95% CI]: 0.851-0.957]) with 96.8% specificity for predicting 28-day neurological prognosis and an AUC of 0.950 (95% CI: 0.911-0.989) with 94.7% specificity for predicting 28-day all-cause mortality, which was the highest among the glucose metabolic reprogramming-related parameters tested.
    CONCLUSIONS: Serum parameters related to glucose metabolic reprogramming were significantly increased after ROSC. Increased serum LDH and pyruvate levels, and lactate/pyruvate ratio may be associated with 28-day poor neurological prognosis and all-cause mortality after ROSC, and the predictive efficacy of LDH during the first week was superior to others.
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