摘要
目的分析血清微小RNA(miR)-125b、miR-142-3p表达与脓毒症患者预后的关系及其预测价值。方法选择2017年1月—2019年10月海南省人民医院重症医学科重症监护室(ICU)住院的脓毒症患者100例作为脓毒症组,同时选取ICU非脓毒症患者90例作为对照组,脓毒症患者根据28 d预后情况分为存活亚组(63例)和死亡亚组(37例)。2组患者入ICU后24 h内,进行APACHEⅡ、SOFA评分,检测血清miR-125b、miR-142-3p表达水平和炎性因子水平。Pearson法分析miR-125b和miR-142-3p与炎性因子相关性;受试者工作特征曲线(ROC)评估血清miR-125b和miR-142-3p对脓毒症患者预后的预测价值。结果脓毒症组患者血清WBC、CRP、PCT、TNF-α、IL-6、IL-1β水平及miR-125b、miR-142-3p的表达水平显著高于对照组(t=8.828、5.764、21.790、18.763、35.251、20.490、10.942、14.427,P均=0.000);存活亚组患者入院时APACHEⅡ评分、SOFA评分、PCT、TNF-α、IL-1β、miR-125b和miR-142-3p水平均低于死亡亚组(t=8.264、5.564、6.412、25.032、10.943、7.905、7.154,P均=0.000);miR-125b与APACHEⅡ评分、SOFA评分、CRP、PCT、TNF-α和IL-6呈正相关(r/P=0.364/0.006、0.313/0.017、0.398/0.001、0.234/0.028、0.437/0.001、0.204/0.041),miR-142-3p与PCT、TNF-α、IL-6和IL-1β呈正相关(r/P=0.293/0.021、0.512/0.000、0.344/0.009、0.418/0.000);血清miR-125b表达水平预测脓毒症患者预后的曲线下面积(AUC)为0.746,最佳临界值为1.74,敏感度和特异度分别为79.57%和72.26%,约登指数为0.518;血清miR-142-3p预测患者预后的AUC为0.685,最佳临界值为2.68,敏感度和特异度分别为68.03%和71.15%,约登指数为0.392。结论脓毒症患者血清miR-125b和miR-142-3p表达升高,且与不良预后有关,二者均与炎性因子具有一定相关性,其中miR-125b对脓毒症患者预后的预测效能较好。
Objective To analyze the relationship between the expression of serum microRNA(miR)125b and miR-142-3p and the prognosis of sepsis patients and their predictive value.Methods One hundred patients with sepsis admitted to the Department of Intensive Medicine of the People's Hospital of Hainan Province from January 2017 to October 2019 were selected as the sepsis group.At the same time,90 patients with non-septic ICU were selected as the control group,and the patients with sepsis were divided into survival subgroup(63 cases)and death subgroup(37 cases)according to the 28-day prognosis.Two groups of patients were scored with APACHEⅡand SOFA within 24 hours after entering the ICU.Serum miR-125b and miR-142-3p expression levels and inflammatory factor levels were detected.Pearson method was used to analyze the correlation between miR-125b and miR-142-3p and inflammatory factors;the receiver operating characteristic curve(ROC)evaluated the predictive value of serum miR-125b and miR-142-3p in the prognosis of sepsis patients.Results Serum levels of WBC,CRP,PCT,TNF-α,IL-6,IL-1βand expression levels of miR-125b and miR-142-3p in the sepsis group were significantly higher than those in the control group(t=8.828,5.764,21.790,18.763,35.251,20.490,10.942,14.427,P=0.000).The APACHEⅡscore,SOFA score,PCT,TNF-α,IL-1β,miR-125b and miR-142-3p levels of patients in the survival subgroup were lower than those in the death subgroup(t=8.264,5.564,6.412,25.032,10.943,7.905,7.154),P=0.000;miR-125b was positively correlated with APACHEⅡscore,SOFA score,CRP,PCT,TNF-αand IL-6(r/P=0.364/0.006,0.313/0.017,0.398/0.001,0.234/0.028,0.437/0.001,0.204/0.041),miR-142-3p was positively correlated with PCT,TNF-α,IL-6 and IL 1β(r/P=0.293/0.021,0.512/0.000,0.344/0.009,0.418/0.000).Serum miR-125b expression level predicts the area under the curve(AUC)of the prognosis of sepsis patients is 0.746,the optimal cut-off value is 1.74,the sensitivity and specificity are 79.57%and 72.26%,and the Youden index is 0.518.Serum miR-142-3p predicted the prognosis of patients with AUC of 0.685,the best cut-off value was 2.68,sensitivity and specificity were 68.03%and 71.15%,and the Youden index was 0.392.Conclusion The expression of serum miR-125b and miR-142-3p in patients with sepsis is increased,and is related to poor prognosis.Both of them have a certain correlation with inflammatory factors.Among them,miR-125b has a better predictive effect on the prognosis of patients with sepsis.
作者
徐志育
谢晓红
朱永
周忠义
雷振林
Xu Zhiyu;Xie Xiaohong;Zhu Yong;Zhou Zhongyi;Lei Zhenlin(Department of Critical Medicine, Hainan People's Hospital, Hainan Province,Haikou 570311,China)
出处
《疑难病杂志》
CAS
2020年第7期714-718,共5页
Chinese Journal of Difficult and Complicated Cases
基金
海南省卫生计生行业科研项目(1801032034A2004)。
