摘要
目的探讨血清微小核糖核酸(microRNA-25)水平对脓毒症患者病情严重程度及预后的评估价值。方法抽取2018年11月至2019年11月山西白求恩医院收治的脓毒症患者166例,其中脓毒症55例,脓毒症休克111例;存活150例,死亡16例。比较不同类别及预后脓毒症患者相关临床指标,采用单因素和多因素Logistic回归分析预后危险因素。结果脓毒症者降钙素原(PCT)、D-二聚体(D-D)、乳酸(Lac)、胱蛋白酶抑制剂C(Cyst-C)、序贯器官衰竭评估量表(SOFA)评分和急性生理和慢性健康状况量表(APACHEⅡ)评分低于脓毒症休克者(P<0.05),脓毒症者血清microRNA-25水平高于脓毒症休克者(P<0.05)。存活者PCT、D-D、Lac、Cyst-C、SOFA评分、APACHEⅡ评分低于死亡者(P<0.05),存活者血清microRNA-25水平高于死亡者(t=10.093,P=0.001)。多因素Logistic回归分析结果显示,Lac、Cyst-C、microRNA-25、SOFA评分是脓毒症患者死亡的独立危险因素(OR=4.186、9.152、0.135、4.359,P=0.034、0.044、0.040、0.004)。结论血清microRNA-25水平下降是脓毒症患者死亡的独立危险因素之一,其可用于临床判断脓毒症患者病情严重程度及预后。
Objective To investigate the value of serum microRNA(microRNA-25)level in evaluating the severity and prognosis of sepsis.Methods A total of 166 sepsis patients admitted to Shanxi Bethune Hospital from November 2018 to November 2019 were selected,including 55 cases of sepsis and 111 cases of septic shock;150 cases survived and 16 cases died.The related clinical indicators of patients with sepsis of different types and prognosis were compared,and univariate and multivariate logistic regression analysis were used to analyze the prognostic risk factors.Results The procalcitonin(PCT),D-dimer(DD),lactic acid(Lac),cystatin C(Cyst-C),sequential organ failure assessment scale(SOFA)and Acute Physiological and Chronic Health Status Scale(APACHEⅡ)scores of sepsis patients were lower than those of septic shock patients(P<0.05),and the levels of microRNA-25 in sepsis patients were higher than that of septic shock patients(P<0.05).The PCT,D-D,Lac,Cyst-C,SOFA score,and APACHEⅡscore in the survivors were lower than those of the dead(P<0.05),and the levels of serum microRNA-25 in the survivors was higher than that of the dead(t=10.093,P=0.001).Multivariate logistic regression analysis showed that Lac,Cyst-C,microRNA-25 and SOFA score were independent risk factors for death in sepsis patients(OR=4.186,9.152,0.135,4.359,P=0.034,0.044,0.040,0.004).Conclusions The drop of serum microRNA-25 level is one of the independent risk factors associated with death of sepsis patients,and which can be used to clinically judge the severity and prognosis of sepsis.
作者
马宁
Ma Ning(Department of Critical Care Medicine,Shanxi Bethune Hospital,Taiyuan 030001,China)
出处
《中国实用医刊》
2020年第18期22-25,共4页
Chinese Journal of Practical Medicine
