首页|重症肺炎合并呼吸衰竭患者外周血miR-24表达与病情及预后的关系

重症肺炎合并呼吸衰竭患者外周血miR-24表达与病情及预后的关系

扫码查看
目的 探讨外周血miR-24表达水平对重症肺炎合并呼吸衰竭患者病情及预后的评估价值.方法 选取2018年10月至2020年12月河北北方学院附属第一医院收治的106例重症肺炎合并呼吸衰竭患者作为重症肺炎组,同期本院收治的184例普通肺炎患者作为普通肺炎组,同期在本院体检的100名健康志愿者作为对照组.采用荧光定量PCR法检测3组研究对象外周血miR-24表达水平.根据治疗结局将重症肺炎合并呼吸衰竭患者的预后分为存活和死亡.采用Pearson相关分析重症肺炎组患者miR-24表达水平与病情评价指标的相关性;采用多因素Cox回归分析重症肺炎组患者预后的影响因素;采用ROC曲线评估miR-24表达水平对重症肺炎组患者预后的预测价值.结果 重症肺炎组患者外周血miR-24表达水平低于普通肺炎组及对照组(均P<0.05).Pearson相关分析显示,重症肺炎组患者miR-24表达水平与CRP、降钙素原(PCT)、APACHE Ⅱ评分均呈负相关(均P<0.05),与PaO2呈正相关(P<0.01).重症肺炎组死亡患者CRP、PCT、APACHE Ⅱ评分均高于存活患者,PaO2、miR-24表达水平均低于存活患者,差异均有统计学意义(均P<0.05).多因素Cox回归分析显示,PaO2、APACHE Ⅱ评分、miR-24均是重症肺炎组患者预后的影响因素(均P<0.05).ROC曲线分析显示,miR-24表达水平预测重症肺炎组患者预后的AUC为0.780(95%CI:0.711~0.889),灵敏度和特异度分别为0.659和0.826.结论 重症肺炎合并呼吸衰竭患者外周血miR-24表达降低与病情加重及预后恶化有关,miR-24可能成为评价病情并预测预后的新标志物.
Correlation of miR-24 expression in peripheral blood with disease severity and prognosis of severe pneumonia patients with respiratory failure
Objective To investigate the correlation of miR-24 expression in peripheral blood with disease severity and prognosis of severe pneumonia patients with respiratory failure.Methods One hundred and six severe pneumonia patients with respiratory failure(severe pneumonia group)and 184 pneumonia patients without respiratory failure(pneumonia group)admitted to the First Affiliated Hospital of Hebei North University from October 2018 to December 2020 were enrolled,and 100 healthy subjects undergoing physical examination served as the control group.The expression level of miR-24 in peripheral blood was detected by fluorescence quantitative PCR.Pearson regression was used to analyze the correlation between the expression of miR-24 and the disease severity in severe pneumonia group;mul-tivariate Cox regression was used to analyze the influencing factors of prognosis;and the ROC curve analysis was used to evaluate the value of miR-24 expression level for predicting the prognosis of severe pneumonia patients.Results The expression level of miR-24 in the peripheral blood of severe pneumonia group was lower than those of pneumonia group and control group(both P<0.05).Pearson correlation analysis showed that miR-24 was negatively correlated with CRP,PCT,APACHE Ⅱ scores(all P<0.05),and positively correlated with PaO2(P<0.01)in severe pneumonia group.The CRP,PCT and APACHE Ⅱ scores of the fatal patients in severe pneumonia group were higher than those of the survival patients,while PaO2 and the expression levels of miR-24 were lower than those of the survival patients(all P<0.05).Multivariate Cox regression analysis showed that PaO2,APACHE Ⅱ score and miR-24 level were influencing factors for the prognosis of severe pneumonia patients with respiratory failure(all P<0.05).ROC curve analysis showed that the AUC of miR-24 expression level to predict the prognosis of patients with severe pneumonia was 0.780(95%CI:0.711-0.889),and the sensitivity and specificity were 0.659 and 0.826,respectively.Conclusion The decreased expression of miR-24 in the peripheral blood is related to the disease severity and prognosis of the patients with severe pneumonia and respiratory failure,indicating that miR-24 may be used as a new marker to evaluate the condition and predict the prognosis in severe pneumonia patients.

Severe pneumoniaRespiratory failuremiR-24PrognosisPredictionInfluencing factors

高飞、张秀梅、金小乐、薛乾隆、王慧、张志斌

展开 >

075000 张家口,河北北方学院附属第一医院急诊科

张家口市沙岭子医院物理治疗室

重症肺炎 呼吸衰竭 miR-24 预后 预测 影响因素

2024

浙江医学
浙江省医学会

浙江医学

CSTPCD
影响因子:0.428
ISSN:1006-2785
年,卷(期):2024.46(7)
  • 19