外周血miR-452、miR-221水平与经皮肾镜钬激光碎石术后并发尿源性脓毒血症的相关性  

Correlation of peripheral blood miR-452 and miR-221 levels with urinary sepsis after percutaneous nephrolithotomy with holmium laser

作　　者：许伟杰 陈家财 赵力 于忠英 朱显钟 李金雨 XU Weijie;CHEN Jiacai;ZHAO Li;YU Zhongying;ZHU Xianzhong;LI Jinyu(Department of Urology,the 909th Hospital of the People's Liberation Army of China/Dongnan Hospital of Xiamen University,Zhangzhou 323000,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇九医院/厦门大学附属东南医院泌尿外科,福建漳州323000

出　　处：《基础医学与临床》2025年第3期298-302,共5页Basic and Clinical Medicine

摘　　要：目的探讨外周血miR-452、miR-221表达水平与经皮肾镜(钬激光)碎石术(PCNL)术后并发尿源性脓毒血症的相关性。方法选取2019年1月至2023年6月,于中国人民解放军联勤保障部队第909医院收治的92例PCNL术后并发尿源性脓毒血症患者作为疾病组,选择同期接诊的92例PCNL术后未并发尿源性脓毒血症患者作为对照组。用RT-qPCR检测外周血miR-452、miR-221表达水平;用Logistic回归分析PCNL术后并发尿源性脓毒血症的影响因素;用受试者工作特征(ROC)曲线评估外周血miR-452、miR-221水平对PCNL术后并发尿源性脓毒血症的诊断效能。结果疾病组患者手术时间长于对照组,外周血miR-452、miR-221水平均高于对照组(P<0.05)。外周血miR-452、miR-221、手术时间、降钙素原(PCT)、C反应蛋白(CRP)、中性粒细胞与淋巴细胞比例(NLR)、尿常规是影响PCNL术后并发尿源性脓毒血症的影响因素(P<0.05)。外周血miR-452、miR-221联合诊断患者PCNL术后并发尿源性脓毒血症的曲线下面积(AUC)为0.888,均优于各自单独检测(Z二者联合-miR-452=2.005、Z二者联合-miR-221=2.972,P<0.05、0.01),敏感度与特异度分别为77.17%、91.30%。结论外周血miR-452、miR-221水平变化与PCNL术后并发尿源性脓毒血症密切相关,联合检测对PCNL术后并发尿源性脓毒血症有较高的诊断效能。Objective To explore the correlation between the expression of microRNA-452(miR-452)and micro-RNA-221(miR-221)in peripheral blood and post-operative urinary sepsis after percutaneous nephrolithotripsy(PCNL).Methods From January 2019 to June 2023,92 patients with post-operative urinary sepsis after PCNL admitted to 909 Hospital of the Chinese People's Liberation Army Joint Logistic Support Force were regarded as the disease group,92 patients who underwent PCNL surgery during the same period without urinary sepsis were collected as control group.RT-qPCR was applied to detect the expression of miR-452 and miR-221 in peripheral blood;Logistic regression was applied to analyze the influencing factors of urinary sepsis after PCNL surgery;Receiver operating characteristic(ROC)curve was applied to evaluate the diagnostic efficacy of peripheral blood miR-452 and miR-221 levels for post-operative urinary sepsis in PCNL patients.Results The time length of the surgical operation in disease group was longer than that in the control group,and the level of miR-452 and miR-221 in peripheral blood,were higher than those in the control group(P<0.05).Peripheral blood miR-452,miR-221,procalcitonin(PCT),C-reactive protein(CRP),neutrophil to lymphocyte ratio(NLR),urine routine and surgical time were all influence factors for post-operative urinary sepsis in PCNL(P<0.05).The area under the curve(AUC)for the combined diagnosis of peripheral blood miR-452 and miR-221 in patients with urinary sepsis after PCNL surgery was 0.888,which was better than their individual detection(Z combination-miR-452=2.005,Z combination-miR-221=2.972,P=0.045,0.003),the sensitivity and specificity were 77.17%and 91.30%,respectively.Conclusions The change of miR-452 and miR-221 level in peripheral blood is closely related to urinary sepsis after PCNL.Combined testing has a high diagnostic efficacy for post-operative urinary sepsis after PCNL surgery.

关 键 词：钬激光 经皮肾镜碎石术 miR-452 MIR-221 尿源性脓毒血症 

分 类 号：R692[医药卫生—泌尿科学]