脓毒症并发ARDS患儿血清miR-424和miR-494表达变化及其临床意义  

Expression changes of serum miR-424 and miR-494 and their clinical significance in patients with sepsis complicated with ARDS

作　　者：曹利芳 伍平 CAO Lifang;WU Ping(Department of Pediatrics,Yongzhou Central Hospital,Yongzhou 425000,China)

机构地区：[1]永州市中心医院儿科,湖南永州425000

出　　处：《山东医药》2023年第13期24-27,共4页Shandong Medical Journal

基　　金：湖南省卫生健康委科研立项课题(201910101249)。

摘　　要：目的探讨脓毒症并发急性呼吸窘迫综合征(ARDS)患儿血清微小RNA-424(miR-424)、微小RNA-494(miR-494)表达变化及其临床意义。方法选择脓毒症并发ARDS患儿213例(并发ARDS组),病情程度:轻度54例、中度86例、重度73例,住院28天内临床结局:死亡62例、存活151例。同期另选单纯脓毒症患儿45例(单纯脓毒症组)、体检健康儿童42例(对照组)。所有研究对象入组后采集外周静脉血,离心留取血清,采用RT-qPCR法检测血清miR-424、miR-494表达。比较三组血清miR-424、miR-494表达以及不同病情程度脓毒症并发ARDS患儿血清miR-424、miR-494表达。分析脓毒症并发ARDS患儿血清miR-424、miR-494表达与氧指数(OI)的关系。采用受试者工作特征(ROC)曲线分析血清miR-424、miR-494表达对脓毒症并发ARDS患儿预后不良的预测价值。结果对照组、单纯脓毒症组、并发ARDS组血清miR-424相对表达量依次降低,血清miR-494相对表达量依次升高(P均<0.01)。随着脓毒症并发ARDS患儿病情加重,血清miR-424相对表达量逐渐降低,血清miR-494相对表达量逐渐升高(P均<0.01)。213例脓毒症并发ARDS患儿OI为13.42(7.96,17.46)。Spearman相关分析显示,脓毒症并发ARDS患儿血清miR-424相对表达量与OI呈负相关关系(r=-0.715,P<0.01),血清miR-494相对表达量与OI呈正相关关系(r=0.779,P<0.01)。ROC曲线分析显示,血清miR-424、miR-494表达预测脓毒症并发ARDS患儿预后不良的曲线下面积分别为0.793(95%CI:0.732~0.845)、0.795(95%CI:0.734~0.847),二者联合预测脓毒症并发ARDS患儿预后不良的曲线下面积为0.906(95%CI:0.858~0.941)。血清miR-424、miR-494表达联合预测脓毒症并发ARDS患儿预后不良的曲线下面积显著高于血清miR-424、miR-494表达单独(Z分别为4.051、4.065,P均<0.01)。结论脓毒症并发ARDS患儿血清miR-424低表达、血清miR-494高表达,二者表达变化与脓毒症并发ARDS病情加重密切相关;miR-424、miR-494有可能成为�Objective To investigate the expression changes of serum microRNA-424(miR-424)and microRNA-494(miR-494)and their clinical significance in children with sepsis complicated with acute respiratory distress syndrome(ARDS).Methods A total of 213 children with sepsis complicated with ARDS were selected(the ARDS group).The severity of the disease was as follows:54 cases were mild,86 cases were moderate,and 73 cases were severe.The clinical outcome within 28 days of hospitalization was as follows:62 cases died and 151 cases survived.During the same period,45 children with simple sepsis(simple sepsis group)and 42 healthy children with physical examination(control group)were selected.Peripheral venous blood of all subjects was collected after inclusion,serum was collected by centrifugation,and the expression of miR-424 and miR-494 in serum was detected by RT-qPCR.The expression levels of miR-424 and miR-494 in serum of the three groups were compared,as well as the expression levels of miR-424 and miR-494 in serum of patients with ARDS complicated by sepsis of different disease degrees.We analyzed the relationship between the expres⁃sion of miR-424 and miR-494 in serum and oxygen index(OI)in children with sepsis complicated with ARDS.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum miR-424 and miR-494 expression for poor prognosis of children with sepsis complicated with ARDS.Results The relative expression level of serum miR-424 in the control group,simple sepsis group and ARDS group decreased successively,while the relative expression level of serum miR-494 increased successively(F=243.987 and 215.859,all P<0.01).With the aggravation of sepsis compli⁃cated with ARDS,the relative expression level of serum miR-424 gradually decreased,and the relative expression level of serum miR-494 gradually increased(F=178.008 and 181.790,all P<0.01).The OI of 213 patients with sepsis compli⁃cated with ARDS was 13.42(7.96,17.46).Spearman correlation analysis showed that the relative expr

关 键 词：脓毒症 急性呼吸窘迫综合征 微小RNA-424 微小RNA-494 儿童 

分 类 号：R631[医药卫生—外科学] R725.6[医药卫生—临床医学]