The predict value of lung ultrasound score and plasma miRNA-21-5p level on the degree and prognosis in septic patients with acute lung injury
Objective To analyse the predictive value of the lung ultrasound score(LUS)and plasma miRNA-21-5p level on the degree and prognosis in septic patients with acute lung injury(ALI).Methods A total of 90 patients with ALI were collected and divided into three groups according to the degree,which were mild group(38 cases,APACHEⅡscores≤10),moderate group(32 cas-es,APACHEⅡscores average was 10-20)and severe group(44 cases,APACHEⅡscores≥20).The plasma levels of miRNA-21-5p,B-type brain natriuretic peptide(BNP),oxygenation index(OI),extravascular lung water index(EVLWI)and LUS were compared among three groups.The correlation degrees of the plasma miRNA-21-5p level and LUS to the APACHEⅡscores were analysed by Pearson correlation analysis.The patients with ALI were divided into two groups,which were survival group(71 cases)and death group(19 cases).The above indexes were compared between two groups.The risk degrees of the above indexes to the prognosis in pa-tients were analysed by multivariate Logistic regression analysis.The clinical values of the plasma miRNA-21-5p and LUS to the prognosis to patients with ALI were analysed by the receiver operating characteristic(ROC)curve.Results The plasma levels of miRNA-21-5p,BNP,EVLWI and LUS in moderate group were lower than severe group(P<0.05),but were higher than mild group(P<0.05).And the index of OI in moderate group were higher than severe group(P<0.05),but were lower than mild group(P<0.05).The levels of D-dimer were no different among three groups(P>0.05).The positive correlation of the plasma levels of miRNA-21-5p lev-el and LUS to the APACHEⅡ scores were confirmed(r=0.857,P=0.026;r=0.795,P=0.036).The plasma levels of miRNA-21-5p,BNP,EVLWI and LUS in death group were higher than in survival group(P<0.05),but the levels of OI were lower than in survival group(P<0.05).By the multivariate Logistic regression analysis,the index of miRNA-21-5p and LUS were the risk factors to the short-term prognosis in patients with ALI(OR=3.656,P=0.013;OR=2.913,P=0.029).The cut-off points of the miRNA-21-5p(3.25)and LUS(17.50)were identified by the ROC curve to predict the poor prognosis of patients with ALI with the sensitivity of 84.2%and speci-ficity of 81.7%(P=0.018).Conclusion The plasma levels of LUS and miRNA-21-5p can evaluate the degree of septic patients with ALI,and has good predictive value of the short-term prognosis.
NETL
NSTL
万方数据
