探讨微小RNA-205预测脓毒症性肾损伤患者28d内转归的价值  

Value of microRNA-205 in predicting prognosis of sepsis-induced acute kidney injury in 28 days

作　　者：陈碧玉[1] 王梅芳[1] 吴呈霖 段敬柱[1] CHEN Biyu;WANG Meifang;WU Chenglin;DUAN Jingzhu(Taihe Hospital,Shiyan Hubei 442000,China)

机构地区：[1]十堰市太和医院,湖北十堰442000

出　　处：《中国急救复苏与灾害医学杂志》2021年第10期1167-1170,共4页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨微小RNA-205(miRNA-205)预测脓毒症性肾损伤患者28 d内转归的临床价值。方法纳入2016年12月-2018年5月因“脓毒症性急性肾损伤(acute kidney injury,AKI)”患者121例,对纳入患者进行外周血miRNA-205水平检测,根据患者28 d内预后情况分为死亡组(n=49)及存活组(n=72),分析miRNA-205在两组患者中的表达差异,应用Pearson相关性分析评价miRNA-205与AKI患者临床指标的关系,通过ROC曲线评估miRNA-205预测此类患者28 d内预后不良的价值,Kaplan-Meier生存分析miRNA-205对28 d内死亡率的影响。结果与存活组相比,死亡患者AKI分期3期比例、Lac、SOFA评分、APACHE II评分、BUN及Cr显著升高,但eGFR、MAP及miRNA-205显著降低,进一步通过Pearson相关性分析可知miR⁃NA-205与SOFA评分呈高度负相关,与eGFR呈高度正相关;同时miRAN-205预测28 d内死亡事件的价值曲线下面积(AUC)(95%CI)为0.84(0.76~0.92);Kaplan-Meier生存分析发现高miRNA-205组生存时间显著高于低miRNA-205组。结论miRNA-205是潜在的预测脓毒症性AKI的指标,是潜在的评估预后的指标。Objective To explore the value of microRNA-205(miRNA-205)in predicting prognosis of sepsis-induced acute kidney injury(AKI)during 28 days after onset.Methods 121 AKI patients,65 males and 56 females,aged(61.39±11.52)(43~76),were hospitalized.Peripheral blood samples were collected to test miRNA-205 by polymerase chain reaction(PCR),The levels of creatinine(Cr),blood urea nitrogen(BUN),llactic acid(Lac)were examined.Estimated glomerular filtration rate(eGFR)were calculated.The prognosis was observed..Sequential organ failure assessment(SOFA)and Acute Physiology and Chronic Health Evaluation II(APACHE II)were conducted.The mean arterial pressure(MAP)during the treatment was monitored.The patients were divided into 2 groups according to the prognosis:49 of them died during the period of 28 days after onset(death group)and 72 survived(survivor group).The relationships of miRNA-205 with the clinical indicators of the AKI patients were evaluated by using Pearson correlation analysis,and ROC curve was used to evaluate the value of miRNA-205 in predicting prognosis of AKI.The impact of miRNA-205 on 28-day mortality was analyzed by using Kaplan-Meier survival analysis.Results The rate of AKI stage 3,SOFA score,APACHE II score,and Lac,BUN and Cr levels of the death group were all significantly higher than those of the survival group,while the levels of eGFR,MAP and miRNA-205 were all significantly lower.miRNA-205 was negatively correlated with SOFA score and positively correlated with eGFR;the area under the value curve(AUC)(95%CI)of miRAN-205 predicting death within 28 days was 0.84(0.76~0.92).Kaplan-Meier survival analysis found that survival time in high miRNA-205 patients was significantly higher than that of low miRNA-205.Conclusion miRNA-205 was a potential predictor of sepsis-induced AKI.

关 键 词：miRNA-205 脓毒症 急性肾损伤 预测 死亡事件 

分 类 号：R196.7[医药卫生—卫生事业管理]