脓毒症并发急性肾损伤患者血清miR-181c和miR-578水平表达及临床意义
Expression Level and Clinical Significance of Serum miR-181c and miR-578 in Patients with Sepsis Complicated by Acute Kidney Injury
宋飞 1李丹 1余梦 1李敏 1丁继 1李兰兰1
作者信息
- 1. 三峡大学第三临床医学院/国药葛洲坝中心医院重症医学科,湖北宜昌 443000
- 折叠
摘要
目的 探讨微小核糖核酸(microRNA,miR)-181c,miR-578在脓毒症并发急性肾损伤(acute kidney injury,AKI)患者血清中的表达水平及临床意义.方法 收集2022年1～12月在国药葛洲坝中心医院住院治疗的80例脓毒症并发AKI患者(AKI组)和80例单纯脓毒症患者(非AKI组)作为研究对象.检测两组血清miR-181c和miR-578水平,并进行组间比较;Logistic回归分析脓毒症患者并发AKI的影响因素;受试者工作特征(receiver operating characteristic,ROC)曲线分析血清miR-181c和miR-578水平对脓毒症患者并发AKI的预测价值.结果 AKI组患者肺部感染所占比例、动脉血乳酸、血肌酐、尿素氮水平以及APACHE Ⅱ评分均高于非AKI组,氧合指数低于非AKI组,差异有统计学意义(χ2=7.364,t=14.298,26.691,17.925,7.104,12.676,均P＜0.05).AKI组患者血清miR-181c水平(1.47±0.36)高于非AKI组(1.03±0.28),而血清miR-578水平(0.76±0.19)显著低于非AKI组(1.05±0.31),差异具有统计学意义(t=8.629,7.134,均P=0.000).Logistic回归分析结果显示,miR-181c[OR(95%CI):2.984(1.628～5.468)]、肺部感染[OR(95%CI):1.946(1.250～3.031)]、动脉血乳酸[OR(95%CI):1.457(1.073～1.978)]、APACHEⅡ评分[OR(95%CI):2.283(1.393～3.741)]是脓毒症患者并发AKI的危险因素(均P＜0.05);miR-578[OR(95%CI):0.742(0.631～0.873)]、氧合指数[OR(95%CI):0.342(0.130～0.904)]是脓毒症患者并发AKI的保护因素(P＜0.05).血清miR-181c和miR-578 二者联合预测脓毒症患者并发AKI的AUC为 0.915(95%CI:0.961～0.953),敏感度和特异度分别为83.65%,88.75%,优于各自单独预测(Z =3.118,3.460,P=0.002,0.001).结论 脓毒症并发AKI患者血清miR-181c表达显著上调,miR-578表达显著下调,二者联合对预测脓毒症并发AKI有较好参考价值.
Abstract
Objective To investigate the expression level and clinical significance of microRNA(miR)-181c and microRNA(miR)-578 in the serum of patients with sepsis complicated by acute kidney injury(AKI).Methods Eighty patients with sepsis complicated by AKI(AKI group)and 80 patients with simple sepsis(non AKI group)who were hospitalized in Sinopharm Gezhouba Central Hospital from January 2022 to December 2022 were collected as research subjects.The serum levels of miR-181c and miR-578 in two groups were detected and compared.Logistic regression was applied to analyze the influencing factors of sepsis patients complicated by AKI.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum miR-181c and miR-578 levels for patients with sepsis complicated by AKI.Results The proportion of pulmonary infection,the level of arterial blood lactic acid,creatinine,urea nitrogen and APACHEⅡ score in AKI group were higher than those in non-AKI group,and the oxygenation index was lower,the differences were statistically significant(χ2=7.364,t=14.298,26.691,17.925,7.104,12.676,all P＜0.05).The serum miR-181c level in the AKI group(1.47±0.36)was higher than that in the non AKI group(1.03±0.28),the serum miR-578 level(0.76±0.19)was lower than that in the non AKI group(1.05±0.31),and the differences were statistically significant(t=8.629,7.134,all P=0.000).Logistic regression analysis showed that miR-181c[OR(95%CI):2.984(1.628～5.468)],pulmonary infection[OR(95%CI):1.946(1.250～3.031)],arterial blood lactic acid[OR(95%CI):1.457(1.073～1.978)],and APACHE Ⅱ score[OR(95%CI):2.283(1.393～3.741)]were risk factors for AKI in sepsis patients(all P＜0.05);miR-578[OR(95%CI):0.742(0.631～0.873)]and oxygenation index[OR(95%CI):0.342(0.130～0.904)]were protective factors(all P＜0.05).The combined prediction of serum miR-181c and miR-578 for AKI in sepsis patients had an AUC of 0.915,a sensitivity and a specificity of 83.65%,88.75%,respectively,which was superior to their individual predictions(Z=3.118,3.460,P=0.002,0.001).Conclusion The serum miR-181c expression is obviously up-regulated and miR-578 expression is obviously down-regulated in patients with sepsis complicated by AKI.The combination of the two has good reference value for predicting sepsis complicated by AKI.
关键词
脓毒症/急性肾损伤/微小核糖核酸-181c/微小核糖核酸-578Key words
sepsis/acute kidney injury/micro RNA-181c/micro RNA-578引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
维普
万方数据