血清CHI3L1、STAT3、TSG-6水平在监测烧伤患者病情和创面愈合程度中的价值

doi:10.3969/j.issn.1673-8640.2026.08.006

摘要/Abstract

摘要：

目的探讨血清壳多糖酶3样蛋白1（CHI3L1）、信号转导及转录激活因子3（STAT3）、肿瘤坏死因子-α刺激基因-6（TSG-6）水平在监测烧伤患者病情和创面愈合情况中的价值。方法选取2022年1月—2023年12月临汾市人民医院烧伤患者85例（烧伤组）和健康体检者85名（正常对照组）。根据烧伤程度将患者分为浅度烧伤组（36例）和深度烧伤组（49例）。对患者治疗28 d后，根据其创面愈合情况分为愈合良好组（32例）和愈合不良组（53例）。收集所有研究对象的临床资料和实验室指标[肿瘤坏死因子-α（TNF-α）、白细胞介素-10（IL-10）、C反应蛋白（CRP）、血小板（PLT）计数]检测结果，并检测血清CHI3L1、STAT3、TSG-6水平。采用Spearman相关分析评估血清CHI3L1、STAT3、TSG-6与烧伤程度的相关性。采用Logistic回归分析评估烧伤患者创面愈合不良的影响因素。采用受试者工作特征（ROC）曲线评估血清CHI3L1、STAT3、TSG-6判断烧伤患者创面愈合不良的效能。结果烧伤组血清CHI3L1、STAT3、TSG-6水平均低于正常对照组（P<0.05）。深度烧伤组血清CHI3L1、STAT3、TSG-6均低于浅度烧伤组（P<0.05）。血清CHI3L1、STAT3、TSG-6与烧伤程度呈负相关（r值分别为-0.412、-0.397、-0.365，P<0.05）。愈合不良组深度烧伤所占比例、APACHEⅡ评分均高于愈合良好组（P<0.05），血清CHI3L1、STAT3、TSG-6水平均低于愈合良好组（P<0.05），2个组之间其他临床资料差异均无统计学意义（P>0.05）。血清CHI3L1、STAT3、TSG-6单项检测和联合检测判断烧伤患者创面愈合不良的AUC分别为0.886、0.895、0.894、0.979。结论血清CHI3L1、STAT3、TSG-6与烧伤患者病情和创面愈合情况密切相关，三者联合检测在判断烧伤患者创面愈合不良中有较高的效能。

关键词: 壳多糖酶3样蛋白1, 信号转导及转录激活因子3, 肿瘤坏死因子α刺激基因-6, 烧伤, 创面愈合

Abstract:

Objective To investigate the roles of serum chitinase 3-like protein 1（CHI3L1），signal transducer and activator of transcription 3（STAT3） and tumor necrosis factor-alpha-stimulated gene-6（TSG-6） levels in monitoring the condition and wound healing of burn patients. Methods A total of 85 burn patients（burn group） and 85 healthy subjects（healthy control group） from Linfen People's Hospital from January 2022 to December 2023 were enrolled. The burn patients were classified into superficial burn group（36 cases）and deep burn group（49 cases）. After 28 d of treatment，the patients were classified into good healing group（32 cases）and poor healing group（53 cases）. The clinical data and clinical laboratory determination results [tumor necrosis factor-alpha（TNF-α），interleukin-10（IL-10），C-reactive protein（CRP），platelet（PLT）count] were collected，and serum CHI3L1，STAT3 and TSG-6 were also determined. Spearman correlation analysis was used to evaluate the correlation between serum CHI3L1，STAT3 and TSG-6 and the degree of burn. Logistic regression analysis was used to evaluate the factors affecting the poor healing of burn patients. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of serum CHI3L1，STAT3 and TSG-6 in judging the poor healing of burn patients. Results The serum CHI3L1，STAT3 and TSG-6 levels in burn group were lower than those in healthy control group（P<0.05）. The serum CHI3L1，STAT3 and TSG-6 levels in deep burn group were lower than those in superficial burn group（P<0.05）. Serum CHI3L1，STAT3 and TSG-6 were negatively correlated with the degree of burn（r values were -0.412，-0.397 and -0.365，respectively，P<0.05）. The proportion of deep burn in poor healing group and the acute physiology and chronic health evaluation（APACHE） Ⅱ score were higher than those in good healing group（P<0.05），and the serum CHI3L1，STAT3 and TSG-6 levels were lower than those in good healing group（P<0.05）. There was no statistical significance in the other clinical data between the 2 groups（P>0.05）. The areas under curves（AUC） of single and combined determinations of serum CHI3L1，STAT3 and TSG-6 for judging the poor healing of burn patients were 0.886，0.895，0.894 and 0.979，respectively. Conclusions Serum CHI3L1，STAT3 and TSG-6 are related to the condition and healing of burn patients，and the combined determination has a high efficacy in evaluating the poor healing of burn patients.

Key words: Chitinase 3-like protein 1, Signal transducer and activator of transcription 3, Tumor necrosis factor-alpha-stimulated gene-6, Burn, Healing

中图分类号:

R446.11

冯胜娟, 赵青毅, 周利民, 柴志杰, 孙偲航, 尚阿勇, 温荣华. 血清CHI3L1、STAT3、TSG-6水平在监测烧伤患者病情和创面愈合程度中的价值[J]. 检验医学, 2026, 41(8): 757-762.

FENG Shengjuan, ZHAO Qingyi, ZHOU Limin, CHAI Zhijie, SUN Sihang, SHANG Ayong, WEN Ronghua. Serum CHI3L1，STAT3 and TSG-6 levels in monitoring the condition and wound healing degree of burn patients[J]. Laboratory Medicine, 2026, 41(8): 757-762.

图/表 6

参考文献 22

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组别	例数	CHI3L1/（ng·mL^-1）	STAT3/（ng·L^-1）	TSG-6/（U·mL^-1）
烧伤组	85	54.05±5.15	19.88±2.98	0.25±0.05
正常对照组	85	68.42±5.02	32.45±3.86	0.38±0.05
t值		17.064	23.765	16.950
P值		<0.001	<0.001	<0.001

组别	例数	CHI3L1/（ng·mL^-1）	STAT3/（ng·L^-1）	TSG-6/（U·mL^-1）
烧伤组	85	54.05±5.15	19.88±2.98	0.25±0.05
正常对照组	85	68.42±5.02	32.45±3.86	0.38±0.05
t值		17.064	23.765	16.950
P值		<0.001	<0.001	<0.001

组别	例数	CHI3L1/（ng·mL^-1）	STAT3/（ng·L^-1）	TSG-6/（U·mL^-1）
浅度烧伤组	36	57.34±5.81	21.63±2.67	0.28±0.04
深度烧伤组	49	51.63±4.12	18.59±2.35	0.23±0.03
t值		5.304	5.562	6.589
P值		<0.001	<0.001	<0.001

组别	例数	CHI3L1/（ng·mL^-1）	STAT3/（ng·L^-1）	TSG-6/（U·mL^-1）
浅度烧伤组	36	57.34±5.81	21.63±2.67	0.28±0.04
深度烧伤组	49	51.63±4.12	18.59±2.35	0.23±0.03
t值		5.304	5.562	6.589
P值		<0.001	<0.001	<0.001

组别	例数		年龄/岁	性别						烧伤总面积/%			烧伤原因
组别	例数		年龄/岁	男/[例（%）]			女/[例（%）]			烧伤总面积/%			火焰烧伤/[例（%）]			其他/[例（%）]
愈合不良组	53		41.25±8.26	33（62.26）			20（37.74）			8.97±2.36			36（67.92）			17（32.08）
愈合良好组	32		40.76±7.18	15（46.88）			17（53.13）			8.41±2.23			20（62.50）			12（37.50）
统计值			0.272	1.922						1.082			0.261
P值			0.786	0.166						0.282			0.609
组别		烧伤深度							ΙL-10/（mg·L^-1）		ΤΝF-α/（μg·L^-1）			CRP/（mg·L^-1）
组别		浅度烧伤/[例（%）]				深度烧伤/[例（%）]			ΙL-10/（mg·L^-1）		ΤΝF-α/（μg·L^-1）			CRP/（mg·L^-1）
愈合不良组		27（50.94）				26（49.06）			158.63±29.26		4.34±1.15			11.91±3.35
愈合良好组		23（71.88）				9（28.13）			147.62±17.90		3.88±0.89			13.32±3.26
统计值		4.255							1.920		1.938			1.899
P值		0.039							0.058		0.056			0.061
组别	PLT计数/（×10⁹L^-1）				APACHEⅡ评分/分			CHI3L1/（ng·mL^-1）				STAT3/（ng·L^-1）			TSG-6/（U·mL^-1）
愈合不良组	64.93±7.96				17.23±2.74			51.32±4.94				18.15±2.54			0.22±0.04
愈合良好组	68.32±7.22				15.33±2.47			58.56±4.56				22.74±3.12			0.30±0.05
统计值	1.969				3.212			6.735				7.399			8.121
P值	0.052				0.002			<0.001				<0.001			<0.001