血清miRNA-192评估呼吸机相关性肺炎患者病情严重度及结局转归的临床价值  

Clinical value of mi RNA-192 in severity and outcomes assessment in patients with ventilator associated pneumonia

作　　者：柳新胜[1] 艾芬[2] 

机构地区：[1]武汉市急救中心姑嫂树路急救站,湖北武汉430000 [2]华中科技大学同济医学院附属武汉市中心医院急诊科,湖北武汉430000

出　　处：《中国医药导报》2016年第4期53-55,92,共4页China Medical Herald

基　　金：湖北省卫生计生委科研立项项目(WJ2015Z075)

摘　　要：目的探讨微小RNA-192（miRNA-192）在呼吸机相关性肺炎（VAP）病情严重度及结局转归中的临床价值。方法前瞻性、连续性纳入武汉市急救中心姑嫂树路急救站及华中科技大学同济医学院附属武汉市中心医院急诊科于2014年3月1～2015年8月接诊的VAP患者,收集相关临床资料、实验室指标及影像学结果。依据预后转归的不同将其分为死亡组及存活组。采用CURB-65评分及肺炎危重度指数（PSI）评估两组患者的病情危重程度,比较两组患者的炎性标志物差异,分析CURB-65评分及PSI分级与炎症标志物的相关性。结果共纳入63例VAP患者,其中1例患者失访。依据随访结果 ,40例成功脱机、22例死亡。与存活组比较,死亡组患者降钙素原（PCT）、超敏C反应蛋白（hs-CRP）、miRNA-192显著增加,差异均有统计学意义（P〈0.05或P〈0.01）;两组PSI及CURB-65评分情况比较,差异均有统计学意义（P〈0.05）。PSI分级与mi RNA-192（r=0.768,P〈0.05）及hsCRP（r=0.496,P〈0.05）呈正相关,其中mi RNA-192的相关性更为显著;CURB-65评分与mi RNA-192（r=0.822,P〈0.05）及PCT（r=0.687,P〈0.05）呈显著正相关。结论 mi RNA-192对于评判VAP患者病情严重度及结局转归具有重要临床价值。Objective To discuss the value of miRNA-192 for severity and outcomes assessment in patients with ventilator associated pneumonia （VAP）. Methods VAP patients from March 2014 to August 2015 in Gusaoshu Road Aid Station of Wuhan Emergency Center and Department of Emergency of Tongji Medical College, Huazhong University of Science and Technology, the Central Hospital of Wuhan were included prospective and continuity. Relevant clinical data, laboratory tests and imaging results were collected. According to the prognosis and outcome, they were divided into death group and survival group. Severity of illness of patients in two groups was assessed by CURB-65 score and pneumonia in critically ill index （PSI）; differences of inflammatory markers between two groups were compared; relationship between CURB-65 score, PSI score and inflammatory markers was analyzed, Results 63 patients with VAP were included, one patient lost to follow-up. On the basis of the results, 40 patients successfully weaning, 22 cases of death. Compared with survival group, procaleitonin （PCT）, high-sensitivity C-reactive protein （hs-CRP）, miRNA-192 of patient in the death group were significantly increased, the differences were statistically significant （P 〈 0.05 or P 〈 0.01）; PSI grading and CURB-65 score of two groups showed statistically significant difference （P 〈 0.05）; PSI grading was positively associated with miRNA-192 （r = 0.768, P 〈 0.05） and hs-CRP （r = 0.496, P 〈 0.05）, and correlation of miRNA-192 was more significant; CURB-65 score was positively associated with miRNA-192 （r = 0,822, P 〈 0.05） and PCT （r = 0.687, P 〈 0.05）. Conclusion miRNA-192 has important clinical value for eygluation of severity and outcome prognosis of VAP disease.

关 键 词：呼吸机相关性肺炎 机械通气 微小RNA-192 

分 类 号：R563.1[医药卫生—呼吸系统]