血浆miR-107-5p、miR-210水平与脓毒症并发急性肾损伤患者肾功能、炎症指标及预后的关系  

Relationship between the levels of plasma miR-107-5p and miR-210 and renal function,inflammatory indicators and prognosis in patients with sepsis complicated with acute kidney injury

作　　者：郑源任 李云婷[1] 冯奇桃 李诗阳[1] 林芳崇 ZHENG Yuanren;LI Yunting;FENG Qitao;LI Shiyang;LIN Fangchong(Department of Emergency,the Second Affiliated Hospital of Hainan Medical College,Haikou,Hainan 570000,China)

机构地区：[1]海南医学院第二附属医院急诊科,海南海口570000

出　　处：《国际检验医学杂志》2021年第11期1327-1332,共6页International Journal of Laboratory Medicine

基　　金：海南省卫生计生行业科研项目(1801320371A2004)。

摘　　要：目的探讨血浆miR-107-5p、miR-210水平与脓毒症并发急性肾损伤(AKI)患者肾功能、炎症指标及预后的关系。方法选择2015年5月至2020年3月该院重症监护病房收治的210例脓毒症患者,其中86例并发AKI(AKI组),124例未并发AKI(NAKI组)。检测2组miR-107-5p、miR-210、肾功能指标[尿素氮(BUN)、血肌酐(Scr)、胱抑素C(Cys-C)]及炎症指标[C反应蛋白(CRP)、降钙素原(PCT)]水平。采用Pearson相关分析miR-107-5p、miR-210水平与BUN、Scr、Cys-C、CRP、PCT之间的相关性。采用Cox比例回归分析miR-107-5p、miR-210与脓毒症并发AKI患者预后的关系;采用受试者工作特征曲线(ROC曲线)及曲线下面积(AUC)分析miR-107-5p、miR-210预测脓毒症并发AKI患者预后的价值。结果AKI组miR-210、miR-107-5p、BUN、Scr、Cys-C、CRP、PCT水平高于NAKI组(P<0.05);AKI组患者入院28 d内死亡33例,存活53例,死亡患者miR-210、miR-107-5p、BUN、Scr、Cys-C、CRP、PCT水平高于存活患者(P<0.05)。Pearson相关分析结果显示miR-210、miR-107-5p水平与BUN、Scr、Cys-C、CRP、PCT呈正相关(P<0.05)。多因素Cox比例回归分析结果显示Cys-C、miR-210、miR-107-5p是脓毒症并发AKI患者死亡的危险因素(OR=2.252、2.149、2.115,P<0.05)。ROC曲线显示,miR-107-5p、miR-210预测脓毒症并发AKI患者死亡的最佳临界值为6.91、7.03,AUC分别为0.878、0.814。结论脓毒症并发AKI患者血浆miR-107-5p、miR-210水平较未并发AKI患者明显增高,二者水平升高与肾损伤程度、炎性反应程度和不良预后相关,可以作为脓毒症并发AKI患者预后评估的辅助指标。Objective To investigate the relationship between the levels of plasma miR-107-5p and miR-210 and renal function,inflammatory indicators and prognosis in patients with sepsis complicated with acute kidney injury(AKI).Methods A total of 210 patients with sepsis admitted to the intensive care unit of the hospital from May 2015 to March 2020 were selected,of which 86 were complicated with AKI(AKI group)and 124 were not complicated without AKI(NAKI group).The levels of miR-107-5p and miR-210,renal function indicators[blood urea nitrogen(BUN),serum creatinine(Scr),cystatin C(Cys-C)]and inflammation indicators[C reactive protein(CRP),procalcitonin(PCT)]were detected in the two groups.Pearson correlation was used to analyze the correlation between the levels of miR-107-5p and miR-210 and BUN,Scr,Cys-C,CRP and PCT.Cox proportional regression was used to analyze the relationship between miR-107-5p and miR-210 and the prognosis of patients with sepsis complicated with AKI.The receiver operating characteristic curve(ROC curve)and area under the curve(AUC)were used to analyze the value of miR-107-5p and miR-210 in predicting the prognosis of patients with sepsis complicated with AKI.Results The levels of miR-210,miR-107-5p,BUN,Scr,Cys-C,CRP and PCT in the AKI group were higher than those in the NAKI group(P<0.05);In the AKI group,33 patients died and 53 patients survived within 28 days after admission,the levels of miR-210,miR-107-5p,BUN,Scr,Cys-C,CRP and PCT in the dead patients were higher than those in the survival patients(P<0.05).Pearson correlation analysis showed that the levels of miR-210 and miR-107-5p were positively correlated with BUN,Scr,Cys-C,CRP,and PCT(P<0.05).Multivariate Cox proportional regression analysis showed that Cys-C,miR-210,miR-107-5p were risk factors for death in patients with sepsis complicated with AKI(OR=2.252,2.149,2.115,P<0.05).The ROC curve showed that the best cut-off values for miR-107-5p and miR-210 to predict the death of patients with sepsis complicated with AKI were 6.91 and 7.03,and

关 键 词：miR-107-5p MIR-210 脓毒症 急性肾损伤 肾功能 炎性反应 预后 

分 类 号：R459.7[医药卫生—急诊医学]