血清微小RNA-146a、细胞间黏附分子-1与急性呼吸窘迫综合征患者病情严重程度和预后的关系  

Association of serum mi R-146a and ICAM-1 with severity and prognosis in patients with acute respiratory distress syndrome

作　　者：周燕 ZHOU Yan(Department of Respiratory and Critical Care Medicine,Zhuji Hospital Affiliated to Wenzhou Medical University,Zhuji,Zhejiang 311800,China)

机构地区：[1]温州医科大学附属诸暨医院呼吸与危重症医学科,浙江诸暨311800

出　　处：《中国卫生检验杂志》2022年第17期2123-2127,2131,共6页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨血清微小RNA(mi RNA)-146a、细胞间黏附分子-1(ICAM-1)与急性呼吸窘迫综合征(ARDS)患者病情严重程度和预后的关系。方法选取2020年1月—2021年6月本院收治的187例ARDS患者为ARDS组,根据病情严重程度与预后分为轻度组(n=32)、中度组(n=61)、重度组(n=94)与死亡组(n=63)和存活组(n=124),另选取本院同期收治的64名体检健康者为对照组。q RT-PCR与ELISA检测血清mi R-146a、ICAM-1水平,Spearman相关性分析ARDS患者血清mi R-146a,ICAM-1水平与氧合指数的相关性,多因素logistic回归分析ARDS患者预后不良影响因素,ROC曲线判断血清mi R-146a、ICAM-1水平对ARDS患者预后不良的预测价值。结果与对照组比较,ARDS组血清mi R-146a、ICAM-1水平升高(P<0.05)。重度组血清mi R-146a、ICAM-1水平高于轻度组、中度组,中度组血清mi R-146a、ICAM-1水平高于轻度组(P<0.05)。mi R-146a、ICAM-1为ARDS患者预后不良的独立危险因素,氧合指数为独立保护因素(P<0.05)。mi R-146a、ICAM-1、mi R-146a+ICAM-1预测ARDS患者预后不良的曲线下面积、敏感度、特异度分别为0.775、0.778、0.859,敏感度分别为100.00%、53.97%、80.95%,特异度分别为50.00%、86.29%、84.68%。mi R-146a+ICAM-1预测ARDS患者预后不良的曲线下面积大于mi R-146a、ICAM-1单独预测。结论ARDS患者血清mi R-146a、ICAM-1水平升高,与病情严重程度和预后密切相关,二者联合能提升预后不良预测价值。Objective To investigate the relationship between serum micro RNA(mi RNA)-146a and intercellular adhesion molecule-1(ICAM-1)and the severity and prognosis of patients with acute respiratory distress syndrome(ARDS).Methods A total of 187 patients with ARDS admitted to our hospital from January 2020 to June 2021 were selected as the ARDS group,and divided into mild(n=32),moderate(n=61),severe(n=94)and death(n=63)and survival(n=124)groups according to the severity and prognosis of their disease,another 64 healthy people admitted to our hospital during the same period for physical examination were selected as the control group.The levels of serum mi R-146a,ICAM-1 were detected by q RT-PCR and ELISA,and the correlation of serum mi R-146a,ICAM-1 levels and oxygenation index in ARDS patients was analyzed by Spearman correlation analysis.Multivariate logistic regression analysis was used to analyze the influencing factors of poor prognosis in ARDS patients.ROC curve was used to determine the predictive value of serum mi R-146a and ICAM-1 levels on poor prognosis in ARDS patients.Results Serum mi R-146a and ICAM-1 levels were increased in the ARDS group compared to the control group(P<0.05).The serum mi R-146a and ICAM-1 levels in the severe group were higher than those in the mild and moderate groups,and the serum mi R-146a and ICAM-1 levels in the moderate group were higher than those in the mild group(P<0.05).mi R-146a and ICAM-1 were independent risk factors for poor prognosis in ARDS patients and oxygenation index was an independent protective factor(P<0.05).The area under the curve of mi R-146a,ICAM-1,and mi R-146a+ICAM-1 in predicting poor prognosis in ARDS patients was 0.775,0.778,and 0.859,with sensitivities of 100.00%,53.97%,and 80.95%,and specificities of 50.00%,86.29%,and84.68%.The area under the curve of mi R-146a+ICAM-1 in predicting poor prognosis of ARDS patients was greater than that of mi R-146a or ICAM-1 alone.Conclusion Elevated serum mi R-146a and ICAM-1 levels in ARDS patients are closely associated

关 键 词：急性呼吸窘迫综合征 炎症 预后 微小RNA-146a 细胞间黏附分子-1 

分 类 号：R563.8[医药卫生—呼吸系统]