稳定期慢性阻塞性肺疾病患者微小RNA-181a表达水平及其与预后的关系  

Expression level of microRNA-181a in patients with stable chronic obstructive pulmonary disease and its relationship with prognosis

作　　者：李翠娟 唐颖[1] 彭翠兰 慕丽娜[1] 杨雪 王春波[1] 李佳[1] 王琳琳 LI Cui-juan;TANG Ying;PENG Cui-lan;MU Li-na;YANG Xue;WANG Chun-bo;LI Jia;WANG Lin-lin(Department of Respiratory Medicine,Daqing Longnan Hospital,Daqing 163453,China)

机构地区：[1]黑龙江省大庆龙南医院呼吸内科,大庆市163453

出　　处：《广西医学》2021年第19期2314-2317,2335,共5页Guangxi Medical Journal

基　　金：黑龙江省医药卫生科研课题(2020-003)。

摘　　要：目的探讨稳定期慢性阻塞性肺疾病(COPD)患者微小RNA(miRNA)-181a表达水平及其与预后的关系。方法选取300例稳定期COPD患者作为COPD组,150例健康志愿者作为对照组。检测并比较两组研究对象外周血miRNA-181a的表达水平及血清促炎细胞因子[肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-1β、IL-6、IL-8、IL-18]的水平。采用Kaplan-Meier曲线分析稳定期COPD患者miRNA-181a及促炎细胞因子水平与预后的关系,并采用Cox回归模型分析稳定期COPD患者预后的影响因素。结果与对照组比较,COPD组患者外周血miRNA-181a的表达水平降低,血清TNF-α、IL-1β、IL-6、IL-8、IL-18的水平升高(均P<0.05)。COPD组miRNA-181a表达水平与TNF-α、IL-1β、IL-6、IL-8、IL-18水平呈负相关(均P<0.05)。Kaplan-Meier曲线分析结果显示,miRNA-181a低表达的COPD患者,以及TNF-α、IL-1β、IL-6、IL-8、IL-18低水平的COPD患者发生急性加重累积发生率和累积病死率更高(均P<0.05)。Cox回归分析结果显示,miRNA-181a、TNF-α、IL-6是COPD组患者发生急性加重的影响因素,miRNA-181a、IL-6、IL-18是COPD组患者死亡的影响因素(均P<0.05)。结论稳定期COPD患者外周血miRNA-181a表达水平降低,其可负调控促炎细胞因子水平,且是稳定期COPD患者发生急性加重和死亡的影响因素。Objective To investigate the expression level of microRNA(miRNA)-181a in patients with stable chronic obstructive pulmonary disease(COPD)and its relationship with prognosis.Methods A total of 300 stable COPD patients were selected as COPD group and 150 healthy volunteers as control group.The expression level of peripheral blood miRNA-181a and the serum levels of pro-inflammatory cytokines(tumor necrosis factorα[TNF-α],interleukin[IL]-1β,IL-6,IL-8,IL-18)of the subjects in the two groups were detected and compared.Kaplan-Meier curve was used to analyze the relationship of miRNA-181a and pro-inflammatory cytokines levels with prognosis in patients with stable COPD,and the Cox regression model was used to analyze the influencing factors of prognosis in patients with stable COPD.Results Compared with the control group,patients in the COPD group exhibited a decreased expression level of peripheral blood miRNA-181a and elevated levels of serum TNF-α,IL-1β,IL-6,IL-8 and IL-18(all P<0.05).The expression level of miRNA-181a negatively correlated with the levels of TNF-α,IL-1β,IL-6,IL-8 and IL-18 in the COPD group(all P<0.05).The results of Kaplan-Meier curve analysis showed that COPD patients with a low expression of miRNA-181a,as well as COPD patients with a low level of TNF-α,IL-1β,IL-6,IL-8 or IL-18,had a higher cumulative incidence rate of acute exacerbation and a higher cumulative fatality rate(all P<0.05).The results of Cox regression analysis showed that,for patients in the COPD group,miRNA-181a,TNF-α,and IL-6 were the influencing factors for acute exacerbation,while miRNA-181a,IL-6,and IL-18 were the influencing factors for death(all P<0.05).Conclusion The expression level of miRNA-181a in peripheral blood of patients with stable COPD is decreased and can negatively regulate the levels of pro-inflammatory cytokines and is an influencing factor for acute exacerbation and death in patients with stable COPD.

关 键 词：慢性阻塞性肺疾病 稳定期 微小RNA-181a 促炎细胞因子 预后 

分 类 号：R563[医药卫生—呼吸系统]