Association between miR-133,CRP,TIM-4 and pulmonary infection disease grade and survival outcome
Objective To explore the association between microRNA133(miR-133),C-reactive protein(CRP),T-cell im-munoglobulin and mucin domain 4(TIM-4)and the severity and survival outcomes of lung infections,and to provide a reference for clinical diagnosis and treatment.Methods A total of 200 patients with lung infection admitted to Ningxia Baoshihua Hospital from May 2020 to May 2023 were selected for infection classification[pneumonia severity index(PSI)score group Ⅰ-Ⅲ(85 cases),PSI score group Ⅳ(81 cases),PSI score group Ⅴ(34 cases)].The expression of miR-133,CRP,and TIM-4 in peripheral blood of each group was analyzed.According to the 28-day survival status,the lung infection patients were divided into survival subgroup and death subgroup.The expression of each index in peripheral blood of the two subgroups in each group was compared,and the relationship between miR-133,CRP,and TIM-4 in peripheral blood,lung infection severity,and survival outcome was analyzed.Results ① There were differences in the expression levels of miR-133,CRP,and TIM-4 in peripheral blood at different time points.② There were differences in the expression levels of miR-133,CRP,and TIM-4 in peripheral blood between the survival group and the death group,and the expression levels of miR-133,CRP,and TIM-4 in peripheral blood were lower in the survival group compared with the death group.③ There were differences in the trends of changes in the expression levels of miR-133,CRP,and TIM-4 in peripheral blood between the survival group and the death group.Three days after admission,the levels of miR-133(OR=1.445,95％CI:1.037-2.014),CRP(OR=1.534,95％CI:1.082-2.174),and TIM-4(OR=1.516,95％CI:1.086-2.116)in peripheral blood were risk factors for mortality in patients with lung infection.Seven days after admission,the levels of miR-133(OR=1.550,95％CI:1.125-2.136),CRP(OR=1.649,95％CI:1.213-2.241),and TIM-4(OR=1.609,95％CI:1.175-2.202)in peripheral blood were also risk factors for mortality in patients with lung infection.On the day of admission,the levels of miR-133(r1=0.645,P<0.001),CRP(r2=0.726,P<0.001),and TIM-4(r3=0.671,P<0.001)in peripheral blood were positively cor-related with the severity of lung infection.The AUC predicted by the combination of indicators three days after admission was 0.941,with a sensitivity of 92.59％and a specificity of 87.86％.The AUC predicted by the combination of indicators seven days after admission was 0.952,with a sensitivity of 88.89％and a specificity of 95.38％.Conclusion The expression levels of miR-133,CRP,and TIM-4 in peripheral blood are positively correlated with the severity of pulmonary infection.The combined prediction of the survival status of patients with pulmonary infection using these three factors has high performance.Patients with high levels of miR-133,CRP,and TIM-4 have a higher risk of mortality in pulmonary infection.Monitoring miR-133,CRP,and TIM-4 can provide guidance for clinical diagnosis and prognosis evaluation.
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