血清miR-122a表达、HMGB1水平对脓毒症并发肝损伤患儿预后的预测效能  

Predictive efficiency of miR-122a expression and HMGB1 level in serum on prognosis of children with SALI

作　　者：马伟科[1] 杨卫国[1] 林燕鸿 张蕾[1] 魏锋 MA Weike;YANG Weiguo;LIN Yanhong;ZHANG Lei;WEI Feng(Shenzhen Children's Hospital,Shenzhen 518038,China;不详)

机构地区：[1]深圳市儿童医院重症医学科,广东深圳518038 [2]深圳市儿童医院消化内科

出　　处：《山东医药》2021年第18期20-24,共5页Shandong Medical Journal

基　　金：广东省医学科研基金资助项目(A20170134)。

摘　　要：目的探讨血清微小RNA-122a(miR-122a)表达、高迁移率族蛋白1(HMGB1)水平对脓毒症并发肝损伤(SALI)患儿预后的预测效能。方法198例脓毒症患儿,根据是否合并肝损伤分为肝损伤组(80例,其中重度37例、中度23例及轻度20例)和无肝损伤组118例,取同期60例体检健康儿童为对照组。采集各组外周静脉血,检测血清miR-122a、HMGB1,采用多因素Logistics回归分析SALI患儿不良预后的影响因素,绘制受试者工作特征曲线(ROC)分析血清miR-122a、HMGB1水平对SALI患儿不良预后的预测价值。结果与对照组比较,肝损伤组血清miR-122a、HMGB1水平均升高,与无肝损伤组、对照组比较,肝损伤组血清miR-122a、HMGB1水平均升高(P均<0.05)。与轻度组比较,中度组血清miR-122a表达、HMGB1水平高(P均<0.05),与中、轻度组比较,重度组血清miR-122a表达、HMGB1水平高(P均<0.05)。重度肝损伤、miR-122a、HMGB1为SALI患儿不良预后独立危险因素(OR分别为2.535,1.807,1.367;95%CI分别为1.345~5.293,1.375~2.466,1.035~1.806;P均<0.05);miR-122a+HMGB1(AUC=0.921,95%CI:0.839~0.970)预测SALI患儿不良预后的敏感度、特异度高于miR-122a表达(AUC=0.793,95%CI:0.688~0.875)、HMGB1(AUC=0.788,95%CI:0.682~0.871)。结论随肝损伤严重程度升高,脓毒症患儿血清miR-122a表达、HMGB1水平升高表达。SALI患儿不良预后的独立危险因素为重度肝损伤、血清miR-122a表达及HMGB1水平升高。血清miR-122a表达、HMGB1水平联合检测可用于预测SALI患儿的不良预后。Objective To explore the predictive efficiency of micro RNA-122a(miR-122a)expression and high-mobility group protein 1(HMGB1)level in serum on the prognosis of children with sepsis-associated liver injure(SALI).MethodsTotally 198 children with sepsis were divided into the liver injury group(80 cases,in which 37 cases were severe,23 cases were moderate and 20 cases were mild)and non-liver injury group(118 cases)according to whether they had liver injury.Totally 60 healthy children were taken as the control group.Peripheral venous blood of children was collected to detect the expression of miR-122a and level of HMGB1 in serum.The influencing factors for poor prognosis in children with SALI were analyzed by multivariate Logistics regression analysis.The receiver operating characteristic curve(ROC)was drawn to analyze the predictive value of miR-122a expression and HMGB1 level in serum on the poor prognosis of the children with SALI.ResultsCompared with the control group,the expression of miR-122a and level of HMGB1in serum increased in the liver injury group.Compared with the non-liver injury group and the control group,the expression of miR-122a and level of HMGB1 in serum in the liver injury group increased(all P<0.05).Compared with the mild group,the expression of miR-122a and the level of HMGB1 in serum of the moderate group were higher(both P<0.05).The expression of miR-122a and level of HMGB1 in serum of the severe group were higher than those in the medium group and the mild group(all P<0.05).Severe liver injury(OR=2.535,95%CI:1.345-5.293),miR-122a(OR=1.807,95%CI:1.375-2.466)and HMGB1(OR=1.367,95%CI:1.035-1.806)were independent risk factors for poor prognosis in children with SALI(all P<0.05).The sensitivity and specificity of miR-122a+HMGB1(AUC=0.921,95%CI:0.839-0.970)in predicting poor prognosis of children with SALI were higher than those of miR-122a(AUC=0.793,95%CI:0.688-0.875)and HMGB1(AUC=0.788,95%CI:0.682-0.871).ConclusionsWith the severity of liver injury,the miR-122a expression and HMGB1 level in ser

关 键 词：微小RNAS 微小RNA-122a表达 高迁移率族蛋白1 脓毒症 肝损伤 

分 类 号：R720.597[医药卫生—急诊医学]