血清NT-proBNP、CHE、miR-155表达水平预测多器官功能障碍综合征患者预后的价值  

Analysis of changes in serum NT-proBNP,CHE and miR-155 expression in patients with multi-organ dysfunction syndrome and their value in prognostic evaluation

作　　者：和亚丽 HE Yali(Department of Critical Care Medicine,Luoyang Dongfang People's Hospital&The Third Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan 471000,China)

机构地区：[1]洛阳市东方人民医院(河南科技大学第三附属医院)重症医学科,河南洛阳471000

出　　处：《淮海医药》2023年第3期244-248,共5页Journal of Huaihai Medicine

摘　　要：目的:探讨多器官功能障碍综合征(MODS)患者血清B型钠尿肽N末端产物(NT-proBNP)、胆碱酯酶(CHE)、微小RNA-155(miR-155)表达水平变化,分析其判断预后的价值。方法:选取某院2019年3月—2022年3月收治的MODS患者86例,根据治疗28 d后预后情况(生存、病死)分为预后良好组(61例)和预后不良组(25例)。比较2组血清NT-proBNP、CHE、miR-155水平及急性生理与慢性健康量表(APACHEⅡ)评分,分析血清NT-proBNP、CHE、miR-155水平与APACHEⅡ评分的相关性,Logistic回归分析影响MODS患者病死的因素,比较各指标不同水平患者病死的危险度。结果:治疗前和治疗7 d后,预后不良组血清NT-proBNP[(2014.25±185.43)pg/mL和(2264.17±204.64)pg/mL]、miR-155表达水平[(1.53±0.26)和(1.47±0.36)]及APACHEⅡ评分[(28.16±4.03)分和(25.58±4.16)分]均高于预后良好组[NT-proBNP:(1713.42±157.64)pg/mL和(1426.37±132.05)pg/mL,miR-155:(1.27±0.33)和(0.95±0.29),APACHEⅡ评分:(21.49±3.67)分和(10.63±2.74)分],CHE水平[(3854.14±363.17)U/L和(3271.43±318.22)U/L]均低于预后良好组[(4507.26±389.11)U/L和(4816.29±413.62)U/L],差异有统计学意义(P<0.05)。治疗前和治疗7 d后,血清NT-proBNP和miR-155表达水平均与APACHEⅡ评分呈正相关,血清CHE水平与APACHEⅡ评分呈负相关,差异有统计学意义(P<0.05)。Logistic回归分析显示,治疗前血清NT-proBNP>1800.87 pg/mL、miR-155>1.35是MODS患者病死的危险因素,血清CHE>4317.40 U/L是MODS患者病死的保护因素;治疗7 d后,血清NT-proBNP>1669.92 pg/mL、miR-155>1.10是MODS患者病死的危险因素,血清CHE>4367.20 U/L是MODS患者病死的保护因素。治疗前,血清NT-proBNP、CHE、miR-155高水平患者病死的危险度是低水平的2.343、0.330、2.419倍(P<0.05);治疗7 d后,血清NT-proBNP、CHE、miR-155高水平患者病死的危险度是低水平的2.571、0.219、3.319倍(P<0.05)。结论:MODS患者血清NT-proBNP、CHE、miR-155水平与病情严重程度相关,临床可根据其表�Objective:To investigate the changes of serum B-type natriuretic peptide N-terminal product(NT-proBNP),cholinesterase(CHE)and microRNA-155(miR-155)expression in patients with multiple organ dysfunction syndrome(MODS)and to analyze their value in prognostic evaluation.Methods:86 patients with MODS admitted to a hospital from March 2019 to March 2022 were selected and divided into a good prognosis group(61 cases)and a poor prognosis group(25 cases)according to their prognosis 28d after treatment.Serum NT-proBNP,CHE,miR-155 levels and Acute Physiological and Chronic Health Scale(APACHEⅡ)scores were compared between the two groups,and the correlation between serum levels of each index and APACHEⅡscores was analyzed.Influencing factors of mortality in the MODS patients were analyzed by logistic regression,and risks of mortality in the patients with different levels of each index were compared.Results:Serum NT-proBNP[(2014.25±185.43)pg/ml,(2264.17±204.64)pg/ml],miR-155 expression levels[(1.53±0.26),(1.47±0.36)]and APACHE II scores[(28.16±4.03),(25.58±4.16)]in the poor prognosis group before and 7d after treatment were higher than those in the good prognosis group[NT-proBNP:(1713.42±157.64)pg/ml,(1426.37±132.05)pg/ml,miR-155:(1.27±0.33),(0.95±0.29),APACHE II scores:(21.49±3.67),(10.63±2.74)],and CHE levels[(3854.14±363.17)U/L,(3271.43±318.22)U/L]were lower than those in the good prognosis group[(4507.26±389.11)U/L,(4816.29±413.62)U/L](P<0.05).Serum NT-proBNP and miR-155 expression levels before and 7d after treatment were positively correlated with APACHE II scores and prognosis,and serum CHE levels were negatively correlated with APACHE II scores and prognosis(P<0.05).Logistic regression analysis showed that serum NT-proBNP(>1800.87 pg/ml)and miR-155(>1.35)levels before treatment and serum NT-proBNP(>1669.92 pg/ml)and miR-155(>1.10)levels 7d after treatment were risk factors for morbidity and mortality in the MODS patients;serum CHE(>4317.40 U/L)levels before treatment and serum CHE(>4367.20 U/L)lev

关 键 词：多器官功能障碍综合征 NT-PROBNP 胆碱酯酶 MIR-155 预后 

分 类 号：R365[医药卫生—病理学]