血清miR-129-5p、miR-103a-3p在重症肺炎并发脓毒症患者中的水平及意义  

Levels and significance of serum miR-129-5p and miR-103a-3p in patients with severe pneumonia complicating sepsis

作　　者：邵丽娇 李宁[1] 王姣 王鑫[1] SHAO Lijiao;LI Ning;WANG Jiao;WANG Xin(Department of Intensive Care Medicine,Hebei Provincial Chest Hospital,Shijiazhuang,Hebei 050000,China)

机构地区：[1]河北省胸科医院重症医学科,河北石家庄050000

出　　处：《检验医学与临床》2024年第12期1750-1754,1758,共6页Laboratory Medicine and Clinic

基　　金：河北省2023年度医学科学研究课题计划(20231217)。

摘　　要：目的探讨微小RNA(miR)-129-5p和miR-103a-3p在重症肺炎并发脓毒症患者血清中的水平及意义。方法收集2021年1月至2022年12月在该院接受治疗的128例重症肺炎并发脓毒症患者(重症肺炎并发脓毒症组)作为研究对象,根据患者入院28 d内的生存情况分为生存组(n=75)和死亡组(n=53);另选取同期在该院体检的128例健康志愿者作为对照组。比较各组血清miR-129-5p、miR-103a-3p及肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、高迁移率族蛋白B1(HMGB1)水平;采用多因素Logistic回归分析影响重症肺炎并发脓毒症患者预后的因素;采用受试者工作特征(ROC)曲线分析血清miR-129-5p、miR-103a-3p水平对重症肺炎并发脓毒症患者预后的预测价值。结果与对照组相比,重症肺炎并发脓毒症组血清miR-129-5p、miR-103a-3p水平明显降低,TNF-α、IL-6、HMGB1水平明显升高,差异均有统计学意义(P<0.05)。死亡组血清miR-129-5p、miR-103a-3p水平明显低于生存组,TNF-α、IL-6、HMGB1水平明显高于生存组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,miR-129-5p、miR-103a-3p水平升高是重症肺炎并发脓毒症患者死亡的保护因素(P<0.05),TNF-α、IL-6、HMGB1水平升高是重症肺炎并发脓毒症患者死亡的危险因素(P<0.05)。血清miR-129-5p、miR-103a-3p单项及联合检测预测重症肺炎并发脓毒症患者死亡的曲线下面积(AUC)分别为0.799(95%CI:0.719~0.865)、0.845(95%CI:0.770~0.903)、0.923(95%CI:0.862~0.963),2项联合检测预测的AUC大于血清miR-129-5p、miR-103a-3p单项检测(Z=3.270,P=0.001;Z=2.843,P=0.005)。结论重症肺炎并发脓毒症患者血清miR-129-5p和miR-103a-3p水平下调,二者联合检测对重症肺炎并发脓毒症患者死亡有较高的预测价值。Objective To explore the levels and significance of serum microRNA-129-5p and miR-103a-3p in the patients with severe pneumonia complicating sepsis.Methods A total of 128 patients with severe pneumonia complicating sepsis(severe pneumonia complicating sepsis group)receiving treatment in this hospital from January 2021 to December 2022 were collected as the research subjects and divided into the survival group(n=75)and death group(n=53)according to the survival status of the patients within 28 d after admission;other 128 healthy volunteers undergoing the physical examination in this hospital during the same period were selected as the control group.The levels of serum miR-129-5p,miR-103a-3p,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and high mobility group protein B1(HMGB1)were compared among the groups;the multiple logistic regression was adopted to analyze the factors affecting the prognosis of the patients with severe pneumonia complicating sepsis;the predictive value of serum miR-129-5p and miR-103a-3p levels on the prognosis of the patients with severe pneumonia complicating sepsis was analyzed by using the receiver operating characteristic(ROC)curves.Results Compared with the control group,the serum miR-129-5p and miR-103a-3p levels in the severe pneumonia complicating sepsis group were significantly reduced,while the levels of TNF-α,IL-6 and HMGB1 were significantly increased,and the differences were statistically significant(P<0.05).The serum miR-129-5p and miR-103a-3p levels in the death group were significantly lower than those in the survival group,while the levels of TNF-α,IL-6,and HMGB1 were significantly higher than those in the survival group,and the differences were statistically significant(P<0.05).The multivariate logistic regression analysis showed that the increase of miR-129-5p and miR-103a-3p levels was the protective factor for the death in the patients with severe pneumonia complicating sepsis(P<0.05),while the increase of TNF-α,IL-6 and HMGB1 levels were the risk factor for the

关 键 词：微小RNA-129-5p 微小RNA-103a-3p 重症肺炎 脓毒症 预后 

分 类 号：R563.1[医药卫生—呼吸系统] R446.11[医药卫生—内科学]