终末期肾脏病血液透析患者血清miR-10a、miR-21水平及预后价值  

The levels and prognostic value of serum miR-10a and miR-21 in end-stage renal disease hemodialysis patients

作　　者：钱睿 黄文辉[1] 李莹屏[1] 卢守燕[1] 董丽婷 贾京京 薛嵘[1] Qian Rui;Huang Wenhui;Li Yingping;Lu Shouyan;Dong Liting;Jia Jingjing;Xue Rong(Department of Nephrology,Gansu Provincial Hospital,Gansu,Lanzhou 730000,China)

机构地区：[1]甘肃省人民医院肾内科,兰州730000

出　　处：《疑难病杂志》2025年第4期468-472,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：甘肃省科技计划项目(24JRRA1057)。

摘　　要：目的探究终末期肾脏病(ESRD)血液透析患者血清微小RNA-10a(miR-10a)、miR-21的表达水平及其对预后的预测价值。方法选取2021年10月—2023年10月于甘肃省人民医院肾内科进行规律血液透析治疗的ESRD患者150例为研究组,随机选择同期医院首次需要进行透析治疗的慢性肾脏病4~5期患者60例为对照组。检测总胆固醇(TC)、三酰甘油(TG)、血肌酐(SCr)、尿素氮(BUN)、尿酸(UA)、肾小球滤过率(eGFR)、血红蛋白(Hb)、C反应蛋白(CRP)、血钙、血磷,以实时荧光定量聚合酶链式反应(RT-qPCR)检测miR-10a、miR-21表达水平;统计研究组患者随访1年后的生存情况;采用受试者工作特征(ROC)曲线分析血清miR-10a、miR-21表达水平对ESRD血液透析患者预后的预测价值;多因素Logistic回归分析ESRD血液透析患者预后的影响因素。结果与对照组比较,研究组血清miR-10a、miR-21表达及SCr水平升高(t/P=7.349/<0.001、8.391/<0.001、18.059/<0.001),eGFR水平降低(t/P=28.867/<0.001);与生存亚组比较,死亡亚组BUN、miR-10a和miR-21表达水平升高,Hb、eGFR水平降低(t/P=5.342/<0.001、8.703/<0.001、8.273/<0.001、2.324/0.022、2.760/0.007);miR-10a、miR-21单独及二者联合预测ESRD血液透析患者预后的AUC分别为0.872、0.826、0.944,二者联合优于各自单独预测效能(Z/P=2.635/0.030、3.294/0.014);eGFR低、血清miR-10a表达水平高、miR-21表达水平高均为ESRD血液透析患者预后死亡的危险因素[OR(95%CI)=1.409(1.100~1.804)、1.364(1.078~1.726)、1.395(1.164~1.671)]。结论ESRD血液透析患者血清中miR-10a、miR-21水平显著上调,且是ESRD血液透析患者预后死亡的危险因素,二者联合对ESRD患者预后具有较高预测价值。Objective To investigate the expression levels of serum microRNA-10a(miR-10a)and microRNA-21(miR-21)in end-stage renal disease(ESRD)hemodialysis patients and their predictive value for prognosis.Methods One hundred and fifty ESRD patients who underwent regular haemodialysis treatment at the Blood Purification Centre,Gansu Provincial Hospital from October 2021 to October 2023 were selected as the study group,and 60 patients with chronic kidney disease stages 4-5 who required dialysis treatment for the first time in our hospital were randomly selected as the control group.Total cholesterol(TC),triacylglycerol(TG),blood creatinine(SCr),urea nitrogen(BUN),uric acid(UA),eGFR,haemoglobin,C-reactive protein(CRP),blood calcium,and blood phosphorus were detected,and the expression levels of miR-10a and miR-21 were detected by real-time fluorescence quantitative polymerase chain reaction(RT-qPCR);the statistics of patients of the study group after 1 year of follow-up Survival and death,the predictive value of serum miR-10a and miR-21 expression levels on the prognosis of ESRD haemodialysis patients was analysed by using subject operating characteristic(ROC)curves,and logistic regression was used to analyse the factors affecting the prognosis of ESRD haemodialysis patients.Results Compared with the control group,the study group had elevated levels of SCr,serum miR-10a,and miR-21 expression(t=18.059,7.349,8.391,P<0.001),and decreased levels of eGFR(t=28.867,P<0.001).Compared with the survival subgroup,the death subgroup BUN,miR-10a and miR-21 expression levels were elevated(t/P=5.342/<0.001,8.703/<0.001,8.273/<0.001),and haemoglobin,eGFR levels were decreased(t/P=2.324/0.022,2.760/0.007);miR-10a,miR-21 alone predicted and both combination predicted the prognosis of SRD haemodialysis patients with AUCs of 0.872,0.826 and 0.944,respectively,and the combination of the two was superior to their respective individual predictive efficacy(Z/P=2.635/0.030,3.294/0.014);low eGFR,serum miR-10a expression level was high,and miR-21 expre

关 键 词：终末期肾脏病 血液透析 微小RNA-10a 微小RNA-21 预后价值 

分 类 号：R692.5[医药卫生—泌尿科学]