血浆miRNA-145、miRNA-183水平在慢性阻塞性肺疾病急性加重期诊断及预后评估中的应用  

Application of plasma miRNA-145 and miRNA-183 level in diagnosis and prognosis evaluation of acute exacerbation of chronic obstructive pulmonary disease

作　　者：高健敏[1] 朱勇德[1] 符国平[1] GAO Jianmin;ZHU Yongde;FU Guoping(Emergency Department,Sanya Central Hospital(Hainan Third People′s Hospital),Sanya,Hainan 572000)

机构地区：[1]三亚中心医院(海南省第三人民医院)急诊科,海南三亚572000

出　　处：《郑州大学学报（医学版）》2022年第4期491-495,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：海南省卫生计生行业科研项目(18A200005)。

摘　　要：目的:分析血浆miRNA-145(miR-145)、miRNA-183(miR-183)水平在慢性阻塞性肺疾病急性加重期(AECOPD)诊断及预后评估中的应用价值。方法:选取2019年6月至2021年6月收治的COPD患者164例,其中AECOPD 102例,稳定期62例,以同期体检健康者82例为对照。采用实时荧光定量PCR法检测血浆miR-145、miR-183表达水平;进行肺功能测试。绘制血浆miR-145、miR-183水平鉴别诊断稳定期COPD和AECOPD的ROC曲线。以死亡为终点事件,分别以血浆miR-145、miR-183水平单独和联合为自变量,辅以性别、年龄作调整因素,进行Cox回归并绘制ROC曲线。结果:AECOPD组血浆miR-145、miR-183水平高于稳定期组,稳定期组高于对照组(P<0.05)。AECOPD组患者血浆miR-145、miR-183水平与第1秒用力呼气容积(FEV1)、FEV1占预计值的百分比(FEV1%)、FEV1占用力肺活量的百分比(FEV1/FVC)均负相关(r_(P)为-0.744~-0.604,P均<0.05)。绘制血浆miR-145、miR-183水平鉴别诊断稳定期和AECOPD的ROC曲线,AUC(95%CI)分别为0.877(0.836~0.917)、0.951(0.942~0.974)。绘制3个回归模型预测预后的ROC曲线,AUC(95%CI)分别为0.883(0.819~0.947)、0.857(0.780~0.935)、0.935(0.889~0.981)。结论:血浆miR-145、miR-183水平可以用于AECOPD与稳定期的鉴别诊断,以及AECOPD预后评估。Aim:To explore the application value of plasma miRNA-145(miR-145)and miRNA-183(miR-183)level in the diagnosis and prognosis evaluation of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:A total of 164 COPD patients from June 2019 to June 2021 were selected,102 cases were AECOPD,and the other 62 cases were COPD in stable phase.A total of 82 healthy people accepted physical examination in the same period were chosen as control.The plasma levels of miR-145 and miR-183 of the 3 groups were detected by real-time fluorescence quantitative PCR,and lung function was evaluated.The differential diagnosis value of the plasma miR-145 and miR-183 levels between AECOPD and COPD in stable phase were analyzed using ROC curve.Cox regression was performed based on that the outcome event was death,the plasma miR-145 or/and miR-183 levels were the independent variables and adjusted by gender and age.The ROC curves of the Cox regression models were drawn.Results:The plasma levels of miR-145 and miR-183 in AECOPD group were higher than those of COPD in stable phase group,and the latter was higher than those of control group(P<0.05).The plasma levels of miR-145 and miR-183 in AECOPD group were negatively correlated with FEV1,FEV1%and FEV1/FVC(Pearson coefficient was-0.744--0.604,P<0.05).The ROC curve AUC(95%CI)of the plasma miR-145 and miR-183 levels for differential diagnosis between AECOPD and COPD in stable phase were 0.877(0.836-0.917),0.951(0.942-0.974),respectively.The ROC curve AUC(95%CI)of the 3 models for predicting the prognosis of AECOPD were 0.883(0.819-0.947),0.857(0.780-0.935),0.935(0.889-0.981),respectively.Conclusion:The plasma levels of miR-145 and miR-183 could be used for the differential diagnosis between AECOPD and COPD in stable phase,and the prognosis evaluation of AECOPD.

关 键 词：急性加重期慢性阻塞性肺疾病 miRNA-145 miRNA-183 预后预测 鉴别诊断 

分 类 号：R563[医药卫生—呼吸系统]