肺部感染相关急性呼吸窘迫综合征影响因素及其miRNA表达水平  

Analysis of risk factors of pulmonary infection-related acute respiratory distress syndrome and the levels of miRNAs expression in patients’ peripheral blood

作　　者：张节平 孙京焕 吴文娟 王硕莹 邢晓莉[1] ZHANG Jie-ping;SUN Jing-huan;WU Wen-juan;WANG Shuo-ying;XING Xiao-li(Tianjin Fifth Central Hospital,Tianjin 300450,China)

机构地区：[1]天津市第五中心医院呼吸内科,天津300450

出　　处：《中华医院感染学杂志》2020年第23期3622-3625,共4页Chinese Journal of Nosocomiology

基　　金：天津市卫生局科技基金资助项目(2014KZ019)。

摘　　要：目的分析4种miRNA(miR-99a、miR-30b、miR-126、miR-26a)在肺部感染致急性呼吸窘迫综合征(ARDS)患者外周血中的表达及预测价值。方法选择2017年1月-2019年12月于天津市第五中心医院住院治疗的肺部感染致ARDS患者80例作为试验组,选择同时期于我院住院治疗的肺部感染且未发生ARDS患者80例作为对照组。采用实时荧光定量聚合酶联反应检测miRNA表达水平,收集两组研究对象的个人资料和实验室指标。结果试验组吸烟比例高于对照组,miR-99a、miR-30b相对表达量高于对照组,miR-126、miR-26a相对表达量低于对照组,差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,吸烟、miR-99a、miR-30b是影响肺部感染致ARDS发生的独立危险因素(P<0.05),miR-126、miR-26a是影响肺部感染致ARDS发生的独立保护因素(P<0.05);ROC曲线分析结果显示,联合预测的曲线下面积为0.897,敏感度为74.0%,特异度为91.7%,联合预测价值高于单一预测。结论外周血miR-99a、miR-30b、miR-126、miR-26a表达可作为早期诊断肺部感染致ARDS的潜在生物标志物。OBJECTIVE To analyze the expression of 4 miRNAs(miR-99 a, miR-30 b, miR-126, miR-26 a) in peripheral blood of patients with acute respiratory distress syndrome(ARDS) caused by pulmonary infection and their predictive value. METHODS Eighty patients with pulmonary infection combined with ARDS who were hospitalized in Tianjin Fifth Central Hospital from Jan. 2017 to Dec. 2019 were recruited as the observation group;another 80 pulmonary infection patients without ARDS were enrolled as the control group. Real-time fluorescence quantitative polymerase chain reaction was used to detect the miRNA expression level, and clinical data of the two groups were collected. RESULTS The proportion of smoking, relative expression levels of miR-99 a and miR-30 b in the observation was significantly higher than that in the control group(P<0.05). Multivariate logistic regression analysis showed that smoking, miR-99 a and miR-30 b were the independent risk factors of ARDS in patients with pulmonary infection(P<0.05), and levels of miR-126 and miR-26 a were independent protective factors(P<0.05). ROC curve analysis showed that, the area under the curve of the combined detection of the four miRNAs were 0.897, the sensitivity was 74.0%, and the specificity was 91.7%, which was significantly higher than that of single detection. CONCLUSION MiR-99 a, miR-30 b, miR-126 and miR-26 a in peripheral blood can be used as potential biomarkers for early diagnosis of ARDS caused by pulmonary infection.

关 键 词：miR-99a miR-30b MIR-126 miR-26a 肺部感染 急性呼吸窘迫综合征 

分 类 号：R563.1[医药卫生—呼吸系统]