摘要
目的:探讨急性呼吸窘迫综合征(ARDS)患者血清Cc16蛋白、miRNA-122的表达水平及其与预后的关系。方法:回顾性分析68例ARDS患者的临床资料,其中死亡组53例,存活组15例,另选取同期健康体检者45例为对照组。采用Kaplan-Meier法分析患者的生存期,应用Logistic分析影响患者预后的因素。结果:ARDS存活组与死亡组平均肺动脉压、平均气道压、肺损伤评分、C反应蛋白、降钙素原、丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、总胆红素、Cc16蛋白和miRNA-122表达水平显著高于对照组,且死亡组C反应蛋白、降钙素原、ALT、AST、总胆红素、Cc16蛋白及miRNA高于存活组(均P <0. 05)。Kaplan-Meier分析显示Cc16蛋白低表达组总体生存率显著高于高表达组(51. 85%vs 18. 15%,P <0. 01),miRNA-122低表达组生存率显著高于高表达组(60. 92%vs20. 13%,P <0. 05);Logistic单因素分析显示ARDS预后与C反应蛋白、降钙素原、ALT、AST、总胆红素、Cc16、miRNA-122相关;Logistic多因素分析显示ALT、Cc16、miRNA-122是影响ARDS预后的独立危险因素。结论:ARDS患者血清Cc16蛋白和miRNA-122表达量异常增高与预后不良密切相关。
Objective: To investigate the expression of serum Cc16 protein and miRNA122 in patients with acute respiratory distress syndrome( ARDS) and their relationship with prognosis. Methods: The clinical data of 68 patients with ARDS were collected,of which 53 were death group and 15 were survival group. Another 45 patients who took part in physical examination at the same time in our hospital were selected as control group. The clinicopathological data of all subjects were collected and the levels of AST,ALT,total bilirubin,serum Cc16 protein,C-Reactive protein and procalcitonin were detected,and the expression of miRNA-122 was detected by RT-q PCR. Kaplan-Meier method was used to analyze the survival time of patients,and Logistic analysis was used to analyze the prognostic factors. Results Mean pulmonary artery pressure,mean airway pressure,lung injury score,C-reactive protein,procalcitonin,ALT,AST,total bilirubin and Cc16 protein in ARDS survival group and death group were significantly higher than those in control group,and C-reactive protein,procalcitonin,ALT,AST,total bilirubin and Cc16 protein in death group were significantly higher than those in survival group( P <0. 05). RT-q PCR showed that the expression level of miRNA-122 in ARDS death group and survival group was significantly higher than that in control group,and that in ARDS death group was significantly higher than that in survival group( P <0. 05). Kaplan-Meier analysis showed that overall survival( OS)( 51. 85%) in miRNA-122 low-expression group was significantly higher than that in high-expression group( 18. 15%)( P = 0. 0085),OS( 60. 92%) in miRNA low-expression group was significantly higher than that in high-expression group( 20. 13%)( P = 0. 0268). Logistic univariate analysis showed that prognosis of ARDS was correlated with CRP,procalcitonin,ALT,AST,total bilirubin,Cc16 and miRNA-122.Logistic multivariate analysis showed that ALT,Cc16 and miRNA-122 were independent risk factors affecting prognosis of ARDS. Conclusion: The expression levels of Cc16 protein and miRNA-122 in ARDS patients are increased,which is closely related to poor prognosis.
作者
公维梅
GONG Wei-mei(Laiwu Central Hospital of Xinwen Mining Group,Laiwu 271100,China)
出处
《内科急危重症杂志》
2020年第1期34-37,共4页
Journal of Critical Care In Internal Medicine
