脓毒症并发ARDS患者血清miR-98-5p、ESM-1、 sTM、VE-Cad水平及其与预后的关系  

Serum miR-98-5p,ESM-1,sTM and VE-Cad in sepsis patients with ARDS and their relationship with prognosis

作　　者：李南 钟昌宝 张娇珍 刘雨莹 龙邦盛 LI Nan;ZHONG Chang-bao;ZHANG Jiao-zhen;LIU Yu-ying;LONG Bang-sheng(Haikou Traditional Chinese Medicine Hospital,Haikou,Hainan 5700o0,China)

机构地区：[1]海口市中医医院检验科,海南海口570000

出　　处：《中华医院感染学杂志》2023年第15期2241-2245,共5页Chinese Journal of Nosocomiology

基　　金：海南省医药卫生科研基金资助项目(1901320241A2005)。

摘　　要：目的 探讨脓毒症并发急性呼吸窘迫综合征(ARDS)患者血清微小核糖核酸-98-5p(miR-98-5p)、内皮细胞特异性分子-1(ESM-1)、可溶性血栓调节蛋白(sTM)、血管内皮钙黏蛋白(VE-Cad)水平变化及其与预后的关系。方法 选取2018年9月-2022年9月海口市中医医院收治的129例脓毒症并发ARDS患者作为研究对象,根据疾病严重程度分为轻度组(39例)、中度组(56例)和重度组(34例)。随访4周后,根据存活情况分为死亡组(52例)和生存组(77例)。比较不同严重程度患者血清miR-98-5p、ESM-1、sTM、VE-Cad水平,死亡组、生存组临床资料,予以多因素Logistic回归分析法分析脓毒症并发ARDS患者的危险因素。采用受试者工作特征(ROC)曲线分析血清miR-98-5p、ESM-1、sTM、VE-Cad水平对脓毒症并发ARDS患者预后的预测价值。结果 血清miR-98-5p水平随严重程度呈降低趋势,血清ESM-1、sTM、VE-Cad水平随严重程度呈升高趋势(P<0.05);血清miR-98-5p水平低、血清ESM-1、sTM、VE-Cad水平高是脓毒症并发ARDS患者死亡的独立危险因素(P<0.05);血清miR-98-5p、ESM-1、sTM、VE-Cad联合检测对预测脓毒症并发ARDS患者预后的敏感度为90.38%,特异度为89.61%,曲线下面积为0.953,联合诊断的诊断价值最高(P<0.05)。结论 血清miR-98-5p、ESM-1、sTM、VE-Cad水平与脓毒症并发ARDS患者病情严重程度具有密切关系,血清miR-98-5p水平低、血清ESM-1、sTM、VE-Cad水平高是脓毒症并发ARDS患者死亡的独立危险因素,且联合检测的诊断价值较高。OBJECTIVE To explore the changes of the levels of serum microribonucleic acid 98-5p(miR-98-5p),endothelial cell specific molecule-1(ESM-1),soluble thrombomodulin(sTM),and vascular endothelial cadherin(VE-Cad)in patients with sepsis complicated with acute respiratory distress syndrome(ARDS)and their relationship with prognosis was analyzed.METHODS Total of 129 patients with sepsis complicated with ARDS admitted to Haikou Traditional Chinese Medicine Hospital from Sep 2018 to Sep 2022 were recruited,and were divided into the mild group(39 cases),the moderate group(56 cases)and the severe group(34 cases)according to the severity of the disease.After 4 weeks of follow-up,they were divided into the death group(52 cases)and the survival group(77 cases)according to the survival condition.The levels of serum miR-98-5p,ESM-1,sTM and VE-Cad among patients with different levels of severity,and the clinical data between the death group and the survival group were compared.And the risk factors for sepsis with ARDS were analyzed by multivariate Logistic regression analysis.The predictive value of the levels of serum miR-98-5p,ESM-1,sTM and VE-Cad on the prognosis of sepsis patients with ARDS was analyzed by receiver operating characteristic(ROC)curve.RESULTS The level of serum miR-98-5p decreased when the disease was severer,while the levels of serum ESM-1,sTM,and VE-Cad increased with the severity(P<0.05).Low serum level of miR-98-5p and high levels of ESM-1,sTM and VECad were independent risk factors for death of septic patients with ARDS(P<0.05).The sensitivity of combined detection of serum miR-98-5p,ESM-1,sTM,and VE-Cad for predicting the prognosis of sepsis complicated with ARDS was 90.38%,with the specificity of 89.61% and the curve of area of 0.953,which showed the highest diagnostic value(P<0.05).CONCLUSION The levels of serum miR-98-5p,ESM-1,sTM and VE Cad were closely related to the severity of sepsis patients with ARDS.Low expression of serum miR-98-5p and high expression of serum ESM-1,sTM and VE-Cad were independ

关 键 词：脓毒症 急性呼吸窘迫综合征 微小核糖核酸-98-5p 内皮细胞特异性分子-1 可溶性血栓调节蛋白 血管内皮钙黏蛋白 

分 类 号：R459.7[医药卫生—急诊医学]