肝硬化上消化道出血患者血清miR⁃210、miR⁃140水平与病情严重程度及预后的关系  

Relationships between serum miR-210 and miR-140 levels and the severity and prognosis of cirrhosis patients with upper gastrointestinal bleeding

作　　者：张萍 叶晓敏[2] 王云 唐雯娟[1] ZHANG Ping;YE Xiaomin;WANG Yun;TANG Wenjuan(Department of Laboratory Medicine,Xichang People′s Hospital,Xichang 615000,Sichuan,China;Department of Gastroenterology,Xichang People′s Hospital,Xichang 615000,Sichuan,China)

机构地区：[1]西昌市人民医院检验科,四川西昌615000 [2]西昌市人民医院消化内科,四川西昌615000

出　　处：《临床检验杂志》2023年第11期844-849,共6页Chinese Journal of Clinical Laboratory Science

摘　　要：目的探讨肝硬化上消化道出血患者血清miR-210、miR-140水平与患者病情严重程度及预后的关系。方法选取2018年2月至2022年6月在西昌市人民医院就诊的203例肝硬化患者作为研究对象,依据是否伴随上消化道出血分为出血组96例,非出血组107例,选择同期体检健康的100例健康志愿者作为健康人对照组。采用qRT-PCR对各组miR-210、miR-140的表达水平进行检测;Spearman相关性分析血清miR-210、miR-140与患者肝功能分级、出血严重程度及血液指标的相关性;多因素COX回归分析肝硬化上消化道出血患者预后的影响因素,采用Kaplan-Meier法分析肝硬化上消化道出血患者血清miR-210、miR-140水平与预后的关系。结果与健康人对照组相比,出血组与非出血组患者国际标准化比值(INR)、纤维蛋白原(Fib)、凝血酶时间(TT)、活化部分凝血酶时间(APTT)、凝血酶原时间(PT)及血清miR-210水平显著升高,清蛋白(Alb)及血清miR-140水平显著下降(P<0.05);与非出血组比较,出血组患者病程、Fib、APTT、肝功能Child分级评分及血清miR-210水平显著上升,Alb及血清miR-140水平显著下降(P<0.05);不同肝功能分级以及不同病情严重程度肝硬化上消化道出血患者血清miR-210、miR-140水平比较差异均有统计学意义(P<0.05);Spearman相关性分析显示,血清miR-210水平与肝功能分级及出血严重程度呈显著正相关,miR-140水平与肝功能分级及出血严重程度呈显著负相关(P<0.05);肝硬化上消化道出血患者在治疗后血清miR-210水平降低,血清miR-140水平升高(P<0.05);多因素COX分析结果显示,病程、肝功能Child分级评分、血清miR-210、miR-140是肝硬化上消化道出血患者预后的影响因素(P<0.05);Kaplan-Meier法分析结果显示,血清miR-210高表达患者6个月内总生存率(73.21%,41/56)显著低于低表达患者(90.00%,36/40),差异有统计学意义(χ^(2)=4.516,P=0.034);miR-140高表达患者6个月内总生存率(Objective To explore the relationships between serum miR-210 and miR-140 levels and the severity and prognosis of cirrhosis patients with upper gastrointestinal bleeding.Methods A total of 203 cirrhosis patients treated in our hospital from February 2018 to June 2022 were selected as the study subjects.These patients were divided into the bleeding group(n=96)and non-bleeding group(n=107)according to whether they were accompanied by upper digestive tract hemorrhage,and 100 healthy volunteers undergoing physical examination in our hospital during the same period were selected as the control group.The expression levels of serum miR-210 and miR-140 were detected by qRT-PCR.Spearman correlation analysis was performed to determine the correlation between serum miR-210 and miR-140 levels and liver function grade,bleeding severity and blood indexes.Multivariate COX regression analysis was used to analyze the influencing factors of prognosis in cirrhosis patients with upper gastrointestinal bleeding.The Kaplan-Meier method was used to analyze the relationship between serum miR-210 and miR-140 levels and prognosis of cirrhosis patients with upper gastrointestinal bleeding.Results Compared with the control group,the international standardized ratio(INR),fibrinogen(Fib),thrombin time(TT),activated partial thrombin time(APTT),prothrombin time(PT)and serum miR-210 levels in the bleeding group and non-bleeding group were significantly increased,while serum albumin(Alb)and miR-140 levels were significantly decreased(P<0.05).Compared with the non-bleeding group,the disease course,Fib,APTT,Child grading score of liver function and serum miR-210 levels in the bleeding group were significantly increased,while serum Alb and miR-140 levels were significantly decreased(P<0.05).There were significant differences in serum miR-210 and miR-140 levels of cirrhosis and upper gastrointestinal bleeding patients with different liver function grades and different severity of disease(P<0.05).Spearman correlation analysis showed that serum miR-210

关 键 词：肝硬化 上消化道出血 MIR-210 miR-140 预后 

分 类 号：R446[医药卫生—诊断学] R575.4[医药卫生—临床医学]