关键词: 胸部创伤； 颗粒蛋白前体； 瓜氨酸组蛋白H3； 分泌型卷曲相关蛋白1； 术后感染

Abstract: Objective To discuss the relationship between serum progranulin (PGRN),citrullinated histone H3 (CitH3),and secreted frizzled-related protein 1 (SFRP1) with postoperative infection in patients with chest trauma. Methods From January 2024 to January 2025,122 patients with chest trauma who underwent surgical treatment in our hospital were selected as the study group,and 124 healthy individuals who passed the health examination were selected as the control group.According to the postoperative infection assessment results,the study group was classified into an infected group of 46 cases and an uninfected group of 76 cases.ELISA method was used to measure serum PGRN,CitH3,and SFRP1.Multivariate Logistic regression was used to explore the risk factors for postoperative infections in patients with chest trauma.ROC curve was used to explore the diagnostic value of serum PGRN,CitH3,and SFRP1 for postoperative infections in patients with chest trauma. Results Compared with the control group,patients in the study group showed significantly elevated levels of serum PGRN [(22.19±2.27) ng/ml vs. (11.75±1.19) ng/ml],CitH3 [(75.10±7.59) pg/ml vs. (37.54±3.78)pg/ml],and SFRP1 [(42.18±4.33)ng/ml vs. (21.62±2.21)ng/ml] were significantly elevated (P<0.05).The neutrophil to lymphocyte ratio(NLR) in the infected group and the non-infected group was 3.07±0.33 and 2.89±0.29 respectively,and the tumor necrosis factor-α(TNF-α) was (45.71±4.59)pg/ml and (48.62±4.89) pg/ml respectively.There was a statistically significant difference between the two groups (P<0.05).The serum PGRN in the infection group and the non-infection group was (23.91±2.42) ng/ml and (21.15±2.18) ng/ml respectively.The CitH3 was (80.81±8.11) pg/ml and (71.64±7.19) pg/ml respectively,and the SFRP1 was (45.41±4.58) ng/ml and (40.23±4.06) ng/ml respectively.There was a statistically significant difference between the two groups (P<0.05).Serum levels of PGRN,CitH3,and SFRP1 in patients with chest trauma were positively correlated with NLR (r=0.431,0.512,0.489) and TNF-α (r=0.426,0.508,0.477) (P<0.05);serum PGRN and CitH3 are positively correlated with SFRP1 (r=0.582,0.376,P<0.05);and serum PGRN is positively correlated with CitH3 (r=0.503,P<0.05).Elevated serum PGRN,CitH3,and SFRP1 were independent risk factors for postoperative infections in patients with chest trauma (P<0.05).The combined diagnostic AUC of serum PGRN,CitH3,and SFRP1 for detecting postoperative infections in patients with chest trauma was superior to that of individual markers (Z=3.520,3.044,3.862,P<0.05). Conclusion Serum PGRN,CitH3,and SFRP1 expression is upregulated in patients with chest trauma and correlates with postoperative infection.The combined use of these three markers holds high diagnostic value for identifying postoperative infection secondary to chest trauma.

Key words: chest trauma; progranulin; citrullinated histone H3; secreted frizzled-related protein 1; postoperative infection