脓毒症患者血小板微粒与微RNA-155水平的变化规律及意义  

Change rule and significance of platelet microparticles and microRNA-155 level in patients with sepsis

作　　者：杨婉花[1] 张宏泽[1] 刘鸿翔[1] 刘长芳[1] 叶冬英[1] 石斌[1] 刘景全[2] 

机构地区：[1]上海交通大学附属第一人民医院松江分院急诊危重病科,上海201600 [2]浙江省人民医院ICU,浙江杭州310014

出　　处：《重庆医学》2016年第5期622-624,627,共4页Chongqing medicine

基　　金：上海市松江区卫生局领先专业课题资助项目(2011SJGG27)

摘　　要：目的探讨血小板微粒(PMPs)和微RNA(miRNA)-155与脓毒症患者病情和预后的关系。方法选择脓毒症患者61例,根据28d预后将其分为存活组和死亡组;根据病情严重程度将其分为脓毒症组、严重脓毒症组及脓毒症休克组。比较各组患者APACHEⅡ评分,使用流式细胞仪进行PMPs定量,利用实时荧光定量PCR检测患者血浆miRNA-155水平。Spearman相关性分析确认PMPs水平、miRNA-155水平与患者APACHEⅡ评分的关系。结果与存活组比较,死亡组患者PMPs水平较高(P<0.05)。脓毒症、严重脓毒症、脓毒症休克3组患者的PMPs水平比较,差异均有统计学意义(P<0.05)。死亡组患者的miRNA-155水平相对于存活组提高(P<0.05),严重脓毒症组及脓毒症休克组患者的miRNA水平较脓毒症组明显提高(P<0.05)。患者PMPs水平及miRNA-155水平均与APACHEⅡ评分呈正相关,同时患者PMPs水平与microRNA-155水平也呈正相关。PMPs水平联合miRNA-155水平预测脓毒症患者死亡的ROC曲线下面积达0.831。结论脓毒症患者的PMPs水平及miRNA-155水平与脓毒症患者的病情及预后有关,miRNA-155可能引起脓毒症患者的PMPs水平增高。Objective To investigate the relationship between platelet microparticles（PMPs）and microRNA-155 with the disease condition and prognosis in the patients with sepsis.Methods 61 patients with sepsis were selected and divided into the survival group and the death group according to the 28 dprognosis.And all cases were divided into the sepsis group,severe sepsis group and sepsis shock group according to the severity of sepsis.The APACHEⅡ scores were compared among various groups.The Spearman correlation analysis was used to determine the correlation between the levels of PMPs and miRNA-155 with the APACHEⅡ scores.The plasma PMPs level was quantitatively detected by the flow cytometry and the plasma miRNA-155 level was detected by the quantitative RT-PCR.The Spearman correlation analysis was performed to determine the relationship between the PMPs and microRNA-155 level with the APACHEⅡscore.Results The PMPs level in the death group was higher than that in the survival group（P〈0.05）.The PMPs level had statistical differences among the sepsis group,severe sepsis group and sepsis shock group（P〈0.05）.The miRNA level in the death group was higher than that in the survival group（P〈0.05）,the miRNA level in the severe sepsis group and the sepsis shock group was increased compared with the sepsis group（P〈0.05）.The levels of PMPs and miRNA-155 were positively correlated with the APACHEⅡscore,meanwhile,the PMPs level in the patients was positively correlated with microRNA-155 level.The area under curve（AUC）of ROC curve in the PMPs combined with miRNA-155 for predicting the death of sepsis patients reached 0.831.Conclusion The PMPs and miRNA-155 levels are correlated with the disease condition and prognosis in the patients with sepsis.miRNA could cause the increase of PMPs level in sepsis patients.

关 键 词：脓毒症 血小板微粒 微RNAS 预后 

分 类 号：R459.7[医药卫生—急诊医学]