碳青霉烯类抗生素联合血液滤过在脓毒性休克患者中的应用及对血清lncRNA XIST和miRNA-130a水平的影响  

Carbapenem antibiotics combined with haemofiltration in patients with septic shock and the effect on serum lncRNA XIST and miRNA-130a

作　　者：曾文驰 张媛莉 陈鸣娣 董宏裕 白晋钊 ZENG Wenchi;ZHANG Yuanli;CHEN Mingdi;DONG Hongyu;BAI Jin-zhao(Department of Critical Care Medicine,the Second Affiliated Hospital of Guangdong Medical University,Zhanjiang 524000,Guangdong,China;不详)

机构地区：[1]广东医科大学附属第二医院重症医学科,广东湛江524000 [2]广东医科大学附属医院重症医学科,广东湛江524000

出　　处：《实用医学杂志》2025年第6期866-871,共6页The Journal of Practical Medicine

基　　金：广东医科大学青年科研培育基金(编号:GDMUQ2022034)。

摘　　要：目的分析碳青霉烯类抗生素联合血液滤过在脓毒性休克患者中的应用及对血清lncRNA XIST和mi RNA-130a的影响。方法前瞻性选取2022年8月至2024年1月在医院治疗的脓毒性休克患者80例,随机分为对照组和观察组各40例,对照组使用碳青霉烯类抗生素,观察组使用碳青霉烯类抗生素与血液滤过联合治疗。观察两组的临床效果,比较两组血流动力学指标[包括心输出量(CO)、中心静脉压(CVP)、平均动脉压(MAP)],免疫功能指标[包括白细胞介素(IL)-6、C反应蛋白(CRP)、肿瘤坏死因子(TNF)-α],氧代谢指标[血氧饱和度(Sa O_(2))、血乳酸(LAC)、氧合指数(Pa O_(2)/Fi O_(2))]以及血清lnc RNA XIST和mi RNA-130a表达水平。结果治疗后,两组CO、CVP、MAP、Sa O_(2)、Pa O_(2)/Fi O_(2)水平与mi RNA-130a表达均上升,而IL-6、CRP、TNF-α、LAC水平与lnc RNA XIST表达下降,与治疗前相比差异有统计学意义(P<0.05)。观察组CO、CVP、MAP水平与mi RNA-130a表达高于对照组,而IL-6、CRP、TNF-α水平与lnc RNA XIST表达低于对照组,差异有统计学意义(P<0.05)。观察组的总有效率高于对照组(χ^(2)=4.501,P<0.05),两组不良反应发生情况无显著差异(χ^(2)=0.180,P>0.05)。结论碳青霉烯类抗生素与血液滤过治疗或通过下调lnc RNA XIST表达,上调mi RNA-130a表达,以及调节炎性因子,改善氧代谢指标,维持患者的血流动力学平衡进而改善脓毒性休克患者的症状。Objective To evaluate the application of carbapenem antibiotics in conjunction with hemofiltration for patients with septic shock and to analyze the impact on serum levels of lncRNA XIST and miRNA-130a.Methods A prospective study was conducted on 80 patients with septic shock treated at our hospital from August 2022 to January 2024.These patients were randomly divided into a control group and an experimental group,each comprising 40 cases.The control group received carbapenem antibiotics,while the experimental group received carbapenem antibiotics in combination with hemofiltration.The clinical outcomes of both groups were evaluated,and comparisons were made regarding their hemodynamic indices[including cardiac output(CO),central venous pressure(CVP),and mean arterial pressure(MAP)],immune function indices[including interleukin-6(IL-6),C-reactive protein(CRP),and tumor necrosis factor-alpha(TNF-α)],oxygen metabolism indices[including blood oxygen saturation(SaO_(2)),blood lactate(LAC),and oxygenation index(PaO_(2)/FiO_(2))],as well as serum levels of lncRNA XIST and miRNA-130a expression.Results Following treatment,the levels of CO,CVP,MAP,SaO_(2),PaO_(2)/FiO_(2),and miRNA-130a were significantly increased,whereas the levels of IL-6,CRP,TNF-α,LAC,and lncRNA XIST were significantly decreased compared to pre-treatment levels(all P<0.05).In comparison with the control group,the experimental group exhibited significantly higher levels of CO,CVP,MAP,and miRNA-130a,as well as significantly lower levels of IL-6,CRP,TNF-α,and lncRNA XIST(all P<0.05).The overall effective rate in the experimental group was significantly higher than that in the control group(χ^(2)=4.501,P<0.05),while no significant difference was observed in the incidence of adverse reactions between the two groups(χ^(2)=0.180,P>0.05).Conclusion Carbapenem antibiotics and hemofiltration therapy can alleviate the symptoms of septic shock patients by downregulating lncRNA XIST expression,upregulating miRNA-130a expression,modulating inflammatory factors

关 键 词：血清lncRNA XIST miRNA-130a 碳青霉烯类抗生素 血液滤过治疗 脓毒性休克 

分 类 号：R459.7[医药卫生—急诊医学]