血清miR-21、miR-155与脓毒症病情程度的相关性及在预后转归中的交互作用  

Correlation of serum miR-21,miR-155 with the severity of sepsis and their interaction in prognosis

作　　者：付君静[1] 陈胜阳[2] FU Jun-jing;CHEN Sheng-yang(Department of Critical Care Medicine,the First Affiliated Hospital of Xinxiang Medical College,Weihui 453100,Henan,CHINA;Department of Anesthesia and Perioperative Medicine,the First Affiliated Hospital of Xinxiang Medical College,Weihui 453100,Henan,CHINA)

机构地区：[1]新乡医学院第一附属医院重症医学科,河南卫辉453100 [2]新乡医学院第一附属医院麻醉与围术期医学科,河南卫辉453100

出　　处：《海南医学》2024年第15期2150-2155,共6页Hainan Medical Journal

基　　金：2018年度河南省医学科技攻关计划联合共建项目(编号:2018020351)。

摘　　要：目的 探讨血清微小RNA-21 (miR-21)、微小RNA-155 (miR-155)与脓毒症病情程度的相关性及在预后转归中的交互作用。方法 选择2022年5月至2023年5月新乡医学院第一附属医院收治的150例脓毒症患者作为研究组,另选同期同年龄段150例健康志愿者作为对照组。比较两组受检者的一般资料和血清miR-21、miR-155水平,并比较研究组不同病情程度患者的血清miR-21、miR-155水平,应用Spearman法分析血清miR-21、miR-155水平与脓毒症病情程度的相关性;统计患者28 d预后,比较死亡与存活患者入院时的血清miR-21、miR-155及常规炎性因子[白介素-6 (IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α (TNF-α)]水平,绘制受试者工作特征(ROC)曲线分析血清miR-21、miR-155及常规炎性因子预测脓毒症预后的价值,通过精准-召回(PR)曲线评价血清miR-21、miR-155及常规炎性因子联合预测脓毒症预后的价值,通过交互作用分析血清miR-21、miR-155在脓毒症预后转归中的作用。结果 研究组患者的血清miR-21、miR-155水平分别为1.93±0.62、1.86±0.55,明显高于对照组的1.05±0.34、0.94±0.31,差异均有统计学意义(P<0.05);研究组病情程度重度患者血清miR-21、miR-155水平分别为2.54±0.54、2.46±0.47,明显高于中度患者的1.95±0.48、1.88±0.44和轻度患者的1.33±0.39、1.27±0.38,中度患者血清miR-21、miR-155水平明显高于轻度患者,差异均有统计学意义(P<0.05);Spearman法分析结果显示,血清miR-21、miR-155水平与脓毒症病情程度呈正相关(P<0.05);死亡患者入院时的血清miR-21、miR-155及IL-6、CRP、TNF-α水平分别为2.63±0.56、2.51±0.52、(1.39±0.42)μg/L、(154.29±28.73) mg/L、(1.18±0.33)μg/L,明显高于存活患者的1.67±0.53、1.62±0.49、(0.97±0.30)μg/L、(122.64±25.19) mg/L、(0.89±0.24)μg/L,差异均有统计学意义(P<0.05);ROC分析结果显示,入院时血清miR-21、miR-155、IL-6、CRP、TNF-α预测脓毒症预后为死亡的曲�Objective To investigate the correlation of serum micrornA-21(miR-21)and micrornA-155(miR-155)with the severity of sepsis and their interaction in prognosis.Methods A total of 150 patients with sepsis ad-mitted to the First Affiliated Hospital of Xinxiang Medical College from May 2022 to May 2023 were selected as the study group,and another 150 healthy volunteers of the same age group in the same period were selected as the control group.The general information and serum levels of miR-21 and miR-155 were compared between the two groups of subjects,and the serum levels of miR-21 and miR-155 were compared among patients with different disease severity levels in the study group.Spearman method was used to analyze the correlation between serum levels of miR-21,miR-155 and the severity of sepsis.The prognosis of patients within 28 days was statistically analyzed.The serum levels of miR-21,miR-155,and conventional inflammatory factors[interleukin-6(IL-6),C-reactive protein(CRP),tumor ne-crosis factor-α(TNF-α)]were compared between dead and surviving patients at admission.The receiver operating char-acteristic(ROC)curve was used to evaluate the predictive value of serum levels of miR-21,miR-155,and conventional inflammatory factors for predicting the prognosis of sepsis.The precision-recall(PR)curve was used to evaluate the predictive value of serum levels of miR-21,miR-155,and conventional inflammatory factors for predicting the prog-nosis of sepsis.The interaction analysis was used to investigate the role of serum levels of miR-21 and miR-155 in the prognosis of sepsis.Results The serum levels of miR-21 and miR-155 in the study group were 1.93±0.62 and 1.86±0.55,respectively,significantly higher than 1.05±0.34 and 0.94±0.31 in the control group(P<0.05).The serum levels of miR-21 and miR-155 in patients with severe illness in the study group were 2.54±0.54 and 2.46±0.47,respectively,sig-nificantly higher than 1.95±0.48,1.88±0.44 in moderate patients and 1.33±0.39,1.27±0.38 in mild patients;the levels in mod

关 键 词：脓毒症 微小RNA-21 微小RNA-155 病情程度 预后 

分 类 号：R631[医药卫生—外科学]