重症肺炎血清miR-147a、miR-21、CD64、APC表达及其对预后的预测价值  

Expressions of serum miR-147a,miR-21,CD64 and APC in patients with severe pneumonia and values in prediction of prognosis

作　　者：迟春天 周建 吴俊沛 侯思聪 宋晨剑 CHI Chun-tian;ZHOU Jian;WU Jun-pei;HOU Si-cong;SONG Chen-jian(Yiwu Central Hospital,Yiwu,Zhejiang 322000,China)

机构地区：[1]义乌市中心医院呼吸与危重症医学科,浙江义乌322000

出　　处：《中华医院感染学杂志》2024年第22期3387-3391,共5页Chinese Journal of Nosocomiology

基　　金：浙江省卫生健康委员会科研基金资助项目(2020RC175)。

摘　　要：目的研究重症肺炎血清微小核糖核酸(miR)-147a、miR-21、簇分化抗原64(CD64)、活化蛋白C(APC)表达及其对预后的预测价值。方法选取2022年1月-2023年7月义乌市中心医院收治的64例重症肺炎患者为重症组,随机选取同期收治的普通肺炎患者71例为普通组,比较重症组和普通组血清miR-147a、miR-21、CD64、APC水平;重症肺炎患者根据住院期间预后情况分为预后不良组和良好组,比较两组血清miR-147a、miR-21、CD64、APC水平,采用受试者工作特征(ROC)曲线分析四指标对重症肺炎患者预后的预测价值。结果重症组血清miR-147a、APC水平低于普通组,血清miR-21、CD64水平高于普通组(P<0.05)。重症肺炎患者预后不良组血清miR-147a、APC水平低于良好组,血清miR-21、CD64水平高于良好组(P<0.05)。血清miR-147a、miR-21、CD64、APC联合预测重症肺炎患者预后的曲线下面积(AUC)值高于四指标单独检测(P<0.05)。结论重症肺炎的发生可引起血清miR-147a、miR-21、CD64、APC水平明显变化,同时四指标联合可有效提高对重症肺炎患者的预测价值,值得在临床推广。OBJECTIVE To observe the expressions of serum micro ribonucleic acid(miR)-147a,miR-21,cluster differentiation antigen 64(CD64)and activated protein C(APC)in the patients with severe pneumonia and analyze the values in prediction of prognosis.METHODS A total of 64 patients with severe pneumonia who were treated in Yiwu Central Hospital from Jan.2022 to Jul.2023 were assigned as the severe group.Meanwhile,71 patients with common pneumonia were chosen as the common group.The levels of serum miR-147a,miR-21,CD64 and APC were compared between the severe group and the common group.The patients with severe pneumonia were divided into the poor prognosis group and the favorable prognosis group according to the prognosis during the hospital stay.The levels of serum miR-147a,miR-21,CD64 and APC were compared between the two groups.The values of the four indexes in prediction of the prognosis of the severe pneumonia patients were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS The levels of serum miR-147a and APC of the severe group were lower than those of the common group,while the levels of serum miR-21 and CD64 of the severe group were higher than those of the common group(P<0.05).The levels of serum miR-147a and APC of the poor prognosis group were lower than those of the favorable prognosis group,while the levels of serum miR-21 and CD64 of the poor prognosis group were higher than those of the favorable prognosis group(P<0.05).The area under curve(AUC)of the joint detection of serum miR-147a,miR-21,CD64 and APC was higher than that of the single detection in prediction of the prognosis of the severe pneumonia patients(P<0.05).CONCLUSIONS The severe pneumonia may lead to the remarkable changes of serum miR-147a,miR-21,CD64 and APC.The joint detection of the four indexes can effectively improve the predictive value for prognosis of the severe pneumonia patients,and it is worthy to be promoted in the hospital.

关 键 词：重症肺炎 预后 微小核糖核酸-147a 微小核糖核酸-21 簇分化抗原64 活化蛋白C 预测价值 

分 类 号：R563.1[医药卫生—呼吸系统]