摘要
[目的]探讨分析microRNA-192表达量与溃疡性结肠炎患者炎性反应及预后的相关性.[方法]选取120例溃疡性结肠炎患者,其中活动期67例,缓解期53例.根据溃疡性结肠炎活动期患者临床严重程度将患者分为轻度组(25例)、中度组(22例)和重度组(20例).检测血清microRNA-192水平,采用Mayo评分、Baron评分,评估患者炎性反应程度,分析microRNA-192水平变化与溃疡性结肠炎患者炎性反应及预后的关系.[结果]活动期患者血清miR-192表达量为(0.19±0.04)显著低于缓解期患者的(0.25±0.07),差异有统计学意义(t=5.906,P＜0.05).重度组患者血清miR-192表达量低于中度组和轻度组,且组间比较差异有统计学意义(P＜0.05);而重度组患者Mayo评分、Baron评分均高于中度组和轻度组,且组间比较差异有统计学意义(P＜0.05).Pearson相关性分析结果显示,血清miR-192表达量与Mayo评分、Baron评分均呈负相关关系(均P＜0.05).复发率为47.50％(57/120),根据预后情况将患者分为复发组(57例)和未复发组(63例).复发组与未复发组患者年龄、体质指数、病变位置、IL-6、IL-15等指标比较差异无统计学意义(P＞0.05),而性别、吸烟、CRP、中性粒细胞胞浆抗体、红细胞沉降率、基底浆细胞增多、血清miR-192表达量与溃疡性结肠炎患者预后有关(P＜0.05).多因素Lo-gistic 回归分析结果显示,性别(OR=1.303,95％CI:1.014～1.675)、吸烟(OR=1.280,95％CI:1.020～1.607)、中性粒细胞胞浆抗体(OR=1.355,95％CI:1.040～1.766)、基底浆细胞增多(OR=1.402,95％CI:1.061～1.852)、miR-192(OR=1.311,95％CI:1.069～1.608)是影响溃疡性结肠炎患者预后的独立危险因素.血清miR-192表达量截断值为0.25时,预测溃疡性结肠炎患者预后的曲线下面积为0.73(95％CI:1.024～1.237),此时的灵敏度和特异度分别为76.36％,69.54％.[结论]溃疡性结肠炎患者血清miR-192表达下降,其水平与患者炎性反应呈负相关关系,检测血清miR-192水平可了解患者炎性反应程度.
Abstract
[Objective]To explore and analyze the correlation between the expression level of microRNA-192 and the inflammatory response and prognosis in patients with ulcerative colitis.[Methods]A total of 120 patients with ulcerative colitis were seleted,of which 67 were in active stage and 53 were in remission.According to the clinical severity of patients with active ulcerative colitis,the patients were divided into a mild group of 25 cases,a moderate group of 22 cases,and a severe group of 20 cases.Then,according to the prognosis,the patients were divided into a recurrence group of 57 cases and a non-recurring group of 63 ca-ses.Serum microRNA-192 levels were detected,Mayo score and Baron score were used to evaluate the de-gree of inflammatory response.The relationship between microRNA-192 level changes and inflammatory response and prognosis in patients with ulcerative colitis were analyzed.[Results]The expression level of serum miR-192 in active patients was(0.19±0.04)lower than that of patients in remission(0.25±0.07),and the difference was statistically significant(t=5.906,P＜0.05).The expression of serum miR-192 in the severe group was lower than that in the moderate group and the mild group,and the difference among the groups was statistically significant(P＜0.05);while the Mayo score and Baron score in the severe group were higher than those in the mild group and the moderate group.The difference among the groups were statistically significant(P＜0.05).Pearson correlation analysis showed that serum miR-192 expres-sion was negatively correlated with Mayo score and Baron score(all P＜0.05).Fifty-seven cases of the 120 patients with ulcerative colitis recurred,the recurrence rate was 47.50％(57/120),63 cases did not re-lapse,and the recurrence rate was 52.50％(63/120).There were no statistically significant differences on the age,body mass index,lesion location,IL-6,IL-15 and other indicators(P＞0.05)between the two groups,while the gender,smoking habit,CRP,neutrophil cytoplasmic antibodies,erythrocyte sedimentation rate,the increase of basal plasma cells and the expression of serum miR-192 were related to the prognosis(P＜0.05).Multivariate logistic regression analysis showed that gender(OR=1.303,95％CI:1.014-1.675),smoking(OR=1.280,95％CI:1.020-1.607),neutrophil cytoplasmic antibody(OR=1.355,95％CI:1.040-1.766),increased basal plasma cells(OR=1.402,95％CI:1.061-1.852),miR-192(OR=1.311,95％CI:1.069-1.608)were the independent risk factors for prognosis.When the cut-off value of serum miR-192 expression was 0.25,the area under the curve for predicting the prognosis of patients with ulcerative colitis was 0.73(95％CI:1.024-1.237),and the sensitivity and specificity at this time were 76.36％and 69.54％,respectively.[Conclusion]The expression of serum miR-192 in patients with ulcera-tive colitis is decreased,and its level is negatively correlated with the patient's inflammatory response.The detection of serum miR-192 level can reflect the degree of the patient's inflammatory response.
维普
万方数据