微小RNA-216a、324-5p、29a在急性胰腺炎患者外周血中的表达及其与并发肝损伤的相关性  

Significance of microRNA 216a,324-5p and 29a expression in peripheral blood in patients with acute pancreatitis and their correlation with liver injury

作　　者：韩永艳[1] 王春耀[2] 杨林[1] 赵国尧[1] 刘慧丽[1] 李景周[1] 陈培莉[1] 崔抗[3] Han Yongyan;Wang Chunyao;Yang Lin;Zhao Guoyao;Liu Huili;Li Jingzhou;Chen Peili;Cui Kang(Department of Intensive Care,First People′s Hospital of Shangqiu City(Shangqiu Clinical College,Xuzhou Medical University),Shangqiu 476100,China;Medical Intensive Care Unit,Peking Union Medical College Hospital,Beijing 100730,China;Department of Oncology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]河南省商丘市第一人民医院(徐州医科大学商丘临床学院)重症监护科,商丘476100 [2]北京协和医院内科重症监护病房,北京100730 [3]郑州大学第一附属医院肿瘤科,郑州450000

出　　处：《中华医学杂志》2020年第27期2126-2131,共6页National Medical Journal of China

基　　金：2018年度河南省高等学校重点科研项目(18B310023)。

摘　　要：目的探讨微小RNA(miR)-216a、miR-324-5p、miR-29a在急性胰腺炎(AP)患者外周血中表达的意义及与胰腺炎并发肝损伤的相关性。方法采用病例对照研究设计,选取2017年6月至2019年5月商丘市第一人民医院收治的130例AP患者,分为轻症AP组(MAP组)和中重症AP组(SAP组),肝损伤组54例(MAP 20例、SAP 34例)与非肝损伤组76例(均为MAP);另选取40名健康志愿者为健康组。比较MAP组、SAP组、健康组以及肝损伤组与非肝损伤组外周血miR-216a、miR-324-5p、miR-29a表达水平,并分析其与临床指标相关性;采用受试者工作特征(ROC)曲线分析外周血各miRNA水平对AP并发肝损伤的预测价值。结果MAP组、SAP组外周血miR-216a、miR-29a水平均高于健康组,miR-324-5p水平低于健康组(均P<0.01);SAP组外周血miR-216a、miR-29a水平均高于MAP组,miR-324-5p水平低于健康组(均P<0.01)。Balthazar CT评分、急性生理与慢性健康状况评分(APACHEⅡ)评分、C反应蛋白水平、住院时间与外周血miR-216a、miR-29a水平均呈正相关(均P<0.05),与miR-324-5p水平呈负相关(均P<0.05)。肝损伤组外周血miR-216a、miR-29a水平高于非肝损伤组,且在肝损伤组中SAP患者高于MAP患者(均P<0.05);肝损伤组外周血miR-324-5p水平低于非肝损伤组,且肝损伤组中SAP患者低于MAP患者(均P<0.05)。外周血miR-216a、miR-324-5p、miR-29a预测AP并发肝损伤的ROC曲线下面积(AUC)分别为0.694、0.750、0.814。结论miR-216a、miR-29a水平在AP患者外周血中表达增高,miR-324-5p水平降低,与Balthazar CT评分、APACHEⅡ评分、C反应蛋白水平、住院时间关系密切,且对AP并发肝损伤有一定预测价值,其中miR-29a预测价值最高。Objective To investigate the significance of microRNA(miR)-216a,miR-324-5p,miR-29a expression in peripheral blood in patients with acute pancreatitis(AP)and their correlation with liver injury.Methods It was a case-control study design.To select 130 AP patients admitted from June 2017 to May 2019 in the First People′s Hospital of Shangqiu,and the patients were divided into mild AP group(MAP group)and moderately severe AP group(SAP group)according to the disease severity,or 54 patients in the liver injury group(20 were MAP and 34 were SAP)and 76 in the non-liver injury group(all were MAP)according to liver injury.And another 40 healthy volunteers were selected as the healthy group.The expressions of miR-216a,miR-324-5p and miR-29a in peripheral blood of MAP group,SAP group,healthy group and liver injury group,non-liver injury group were compared,and the correlation between the miRNA levels and clinical indexes was analyzed.The predictive value of miRNA levels in peripheral blood for AP complicated with liver injury was analyzed by receiver operating characteristic(ROC)curve.Results The levels of miR-216a and miR-29a in MAP group and SAP group were higher than those in healthy group,and the level of miR-324-5p was lower than that in healthy group(all P<0.01).The levels of miR-216a and miR-29a in SAP group were higher than those in MAP group,and the level of miR-324-5p was lower than that in healthy group(all P<0.01).Balthazar CT Score,acute physiology and chronic health evaluations(APACHEⅡ)score,C-reactive protein level,length of hospital stay were positively correlated with the levels of miR-216a and miR-29a in peripheral blood(all P<0.05),and negatively correlated with the levels of miR-324-5p(P<0.05).The levels of miR-216a and miR-29a in the peripheral blood in the liver injury group were higher than those in the non-liver injury group,and they were higher inSAP patients than those in MAP patients in the liver injury group(all P<0.05).The level of miR-324-5p in the peripheral blood in the liver injury group

关 键 词：急性胰腺炎 肝损伤 微小RNA-216a 微小RNA-324-5p 微小RNA-29a 

分 类 号：R576[医药卫生—消化系统]