TLR4、NF-κB及miR-146a、miR-21预测子宫切除术后患者肺部感染的价值  

The value of TLR4,NF-κB,miR-146 a and miR-21 in predicting pulmonary infection in patients after hysterectomy

作　　者：高彦军 贾小梅 GAO Yanjun;JIA Xiaomei(Department of Anesthesiology,Shenmu Hospital,Northwest University,Shenmu,Shaanxi,China,719399)

机构地区：[1]西北大学附属神木医院麻醉科,陕西神木719399

出　　处：《分子诊断与治疗杂志》2025年第2期291-294,299,共5页Journal of Molecular Diagnostics and Therapy

基　　金：陕西省2021年科技计划项目(2021SF-055)。

摘　　要：目的探讨血清TOLL样受体4(TLR4)、核因子-κB(NF-κB)信使核糖核酸(mRNA)及微小核糖核酸-146a(miR-146a)、微小核糖核酸-21(miR-21)预测全麻子宫切除术后患者肺部感染发生的临床价值,并分析其危险因素。方法选取于西北大学附属神木医院接受全麻子宫切除术患者298例作为研究对象,病例收集时间为2021年1月至2023年12月,根据术后是否发生肺部感染,分为A组(感染者,52例)和B组(未感染者,246例)。分析全麻子宫切除术患者术后肺部感染的单因素、多因素,比较两组血清TLR4 mRNA、NF-κB mRNA、miR-146a、miR-21水平,将A组纳入阳性,B组纳入阴性,绘制受试者工作特征曲线(ROC),分析血清TLR4 mRNA、NF-κB mRNA、miR-146a、miR-21水平单独及联合检测对全麻子宫切除术患者术后肺部感染的预测价值。结果A组年龄高于B组,伴有糖尿病基础疾病的患者占比高于B组,手术时间、术后卧床时间则长于B组,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,全麻子宫切除术患者术后肺部感染的独立危险因素主要包括:手术时间较长、年龄偏高、术后卧床时间较长、糖尿病(P<0.05)。较B组,A组血清TLR4 mRNA、NF-κB mRNA、miR-21、miR-146a水平均更高,差异有统计学意义(P<0.05)。将A组纳入阳性,B组纳入阴性进行ROC分析,结果显示,血清TLR4 mRNA、NF-κB mRNA、miR-146a、miR-21水平联合检测预测全麻子宫切除术患者术后肺部感染的曲线下面积(AUC)为0.898,高于单独检测(P<0.05)。结论全麻子宫切除术后肺部感染发生的危险因素较多,血清TLR4 mRNA、NF-κB mRNA、miR-146a、miR-21联合对其进行预测更具优势。Objective To investigate the clinical value of serum TOLL-like receptor 4(TLR4),nuclear factor-κB(NF-κB)messenger ribonucleic acid(mRNA),microRNA-146a(miR-146a)and microRNA-21(miR-21)in predicting pulmonary infection in patients after hysterectomy under general anesthesia,and to analyze its risk factors.Methods 298 cases of hysterectomy under general anesthesia at Shenmu Hospital affiliated with Northwest University were selected as the research subjects.These cases were collected from January 2021 to December 2023.They were categorizeded into two groups based on the occurrence of postoperative pulmonary infection:group A(52 infected cases)and group B(246 uninfected cases).The aim of the study was to analyze the single and multiple factors contributing to postoperative pulmonary infection in patients undergoing general anesthesia hysterectomy.A comparrson was made between the serum levels of TLR4 mRNA,NF-κB mRNA,miR-146a,and miR-21 in the two groups.Group A was considered positive,while group B was considered negative.Additionally,a receiver operating characteristic curve(ROC)was drawn to assess the predictive value of serum levels of TLR4 mRNA,NF-κB mRNA,miR-146a,and miR-21 for postoperative pulmonary in fection in patients undergoing general anesthesia hysterectomy.Results The age of group A is higher than that of group B,the proportion of patients with basic diabetes is also higher in group B,and the operation time and postoperative bed rest time are longer in group A compared to group B.These differences were statistically significant(P<0.05).Logistic regression analysis showed that the independent risk factors for postoperative pulmonary infection in patients undergoing hysterectomy under general anesthesia mainly include:longer operation time,older age,longer bed rest after operation and diabetes(P<0.05).In comparison to group B,the levels of serum TLR4 mRNA,NF-κB mRNA,miR-21,and miR-146a were higher in group A,with statistically significant differences(P<0.05).Group A was designated as the positive gr

关 键 词：TOLL样受体4 核因子-ΚB 信使核糖核酸 微小核糖核酸-146a 微小核糖核酸-21 

分 类 号：R713.4[医药卫生—妇产科学] R563.1[医药卫生—临床医学]