miR-150时序变化在脓毒症诊断和预后中的价值研究
发布时间：2018-07-28 15:37
【摘要】：目的:探讨mi R-150的时序变化在早期诊断脓毒症及判断病情严重程度和预后中的价值。方法:选取新疆石河子大学医学院第三附属医院2016年2月至2017年1月54例脓毒症患者为病例组,并分为脓毒症组和感染性休克组,同时选取30名同期健康者为对照组。病例组分别在治疗前(D0)和治疗后第1天(D1)、第2天(D2)、第3天(D3)、第7天(D7)抽取静脉血标本,采用荧光定量PCR方法检测血浆中mi R-150,化学发光法测定血清中降钙素原(PCT)、IL-6,免疫比浊法测定C反应蛋白(CRP)表达水平,计算以上各时间点序贯器官衰竭估计评分(SOFA)、急性生理与慢性健康评分(APACHEII);28天随访预后;对照组在入组时采集血液标本,同方法检测上述指标。采用t检验或Mann-Whitney U检验比较两组间各时间点的mi R-150的表达水平,单因素方差分析法比较两组内以上各时间点的mi R-150的变化情况,采用Pearson相关系数分析各指标与SOFA评分、APCACHE II评分的关系,采用受试者工作特征曲线(ROC)分析mi R-150对脓毒症患者的早期诊断和预后的预测价值。结果:(1)病例组与对照组比较,各时间点mi R-150表达水平升高(P0.01);mi R-150表达水平由D0时明显升高,于D2达到最高峰,随后下降,D7时低于D0,但无统计学意义(P0.05);(2)mi R-150诊断脓毒症的ROC曲线显示,mi R-150的曲线下面积(AUC)为0.83,cut-off值为2.88,敏感性、特异性分别为69%,93%,其AUC低于PCT、CRP(P0.05),但高于IL-6(P0.05),IL-6的AUC最小;(3)感染性休克组mi R-150表达水平在D0、D3均明显高于脓毒症组(P0.05),D1、D2、D7时高于脓毒症组,但两组间差异无统计学意义(P0.05);D0时感染性休克组SOFA评分、APACHEII评分均高于脓毒症组(P0.05);经Pearson相关系数分析显示,病例组D0时mi R-150与SOFA评分、APACHEII评分均呈正相关;(4)存活组D0时mi R-150水平明显低于死亡组,差异具有统计学意义(P0.05);同时SOFA评分、APACHEII评分明显低于死亡组,差异具有统计学意义(P0.05);mi R-150预测脓毒症预后的ROC曲线显示,mi R-150的曲线下面积(AUC)为0.77,其低于PCT(P0.05),高于CRP、IL-6(P0.05),IL-6的AUC最小。结论:血浆mi R-150在脓毒症病程中表达稳定、表达上调,可能是潜在的生物标记物;mi R-150与脓毒症病情严重程度相关,病情越严重表达水平越高;mi R-150在脓毒症早期诊断和预后预测中有潜在的价值。
[Abstract]:Objective: to investigate the value of the timing changes of miR-150 in the early diagnosis of sepsis and in judging the severity and prognosis of sepsis. Methods: 54 patients with sepsis from February 2016 to January 2017 in the third affiliated Hospital of Medical College of Shihezi University were divided into sepsis group and septic shock group and 30 healthy persons were selected as control group. Venous blood samples were collected before and after treatment (D1), 2nd (D2), 3rd (D3), 7th (D7) in the case group, respectively, before treatment (D0) and on the first day (D1), the second day (D2), the third day (D3), and the 7th day (D7), respectively. The plasma miR-150 was detected by fluorescence quantitative PCR, the serum calcitonin proto (PCT) IL-6 was detected by chemiluminescence assay, and the expression of C-reactive protein (CRP) was detected by immunoturbidimetric method. The (SOFA), acute physiological and chronic health score (APACHEII) was followed up for 28 days, and the blood samples were collected at the time of entry of the control group, and the above indexes were detected by the same method. T test or Mann-Whitney U test were used to compare the expression level of miR-150 at each time point between the two groups, and single-factor variance analysis was used to compare the changes of miR-150 between the two groups at each time point above. The correlation coefficient of Pearson was used to analyze the relationship between each index and the SOFA score and Apache II score. The (ROC) analysis of the operating characteristic curve was used to analyze the predictive value of miR-150 in the early diagnosis and prognosis of sepsis patients. Results: (1) compared with the control group, the expression level of miR-150 increased significantly (P0.01) at different time points (P0.01) and reached its peak at D2. However, the ROC curve of miR-150 for the diagnosis of sepsis had no statistical significance (P0.05); (2). The area under the curve of MMI R-150 was 0.83 cut-off value (2.88), which showed that the area under the curve was 0.83 and the sensitivity was 2.88. The specificity was 69 / 93.The AUC was lower than that of IL-6 (P0.05), but higher than that of IL-6 (P0.05) IL-6. (3) the expression level of miR-150 in septic shock group was significantly higher than that in septic group (P0.05), and was higher than that in septic group (P0.05). However, there was no significant difference between the two groups (P0.05). The SOFA score of septic shock group was higher than that of septic group (P0.05). There was a positive correlation between miR-150 and SOFA score and Apache II score at D0. (4) the level of miR-150 in survival group was significantly lower than that in death group (P0.05), and the SOFA score was significantly lower than that in death group. The ROC curve for predicting the prognosis of sepsis showed that the area under the curve of MMI R-150 was 0.77, which was lower than that of PCT (P0.05), and higher than that of AUC with IL-6 (P0.05). Conclusion: the expression of plasma miR-150 is stable and up-regulated in the course of sepsis, which may be a potential biomarker associated with the severity of sepsis. The more severe the disease, the higher the expression level of mi-R-150 has potential value in early diagnosis and prognosis prediction of sepsis.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R459.7
本文编号：2150741
[Abstract]:Objective: to investigate the value of the timing changes of miR-150 in the early diagnosis of sepsis and in judging the severity and prognosis of sepsis. Methods: 54 patients with sepsis from February 2016 to January 2017 in the third affiliated Hospital of Medical College of Shihezi University were divided into sepsis group and septic shock group and 30 healthy persons were selected as control group. Venous blood samples were collected before and after treatment (D1), 2nd (D2), 3rd (D3), 7th (D7) in the case group, respectively, before treatment (D0) and on the first day (D1), the second day (D2), the third day (D3), and the 7th day (D7), respectively. The plasma miR-150 was detected by fluorescence quantitative PCR, the serum calcitonin proto (PCT) IL-6 was detected by chemiluminescence assay, and the expression of C-reactive protein (CRP) was detected by immunoturbidimetric method. The (SOFA), acute physiological and chronic health score (APACHEII) was followed up for 28 days, and the blood samples were collected at the time of entry of the control group, and the above indexes were detected by the same method. T test or Mann-Whitney U test were used to compare the expression level of miR-150 at each time point between the two groups, and single-factor variance analysis was used to compare the changes of miR-150 between the two groups at each time point above. The correlation coefficient of Pearson was used to analyze the relationship between each index and the SOFA score and Apache II score. The (ROC) analysis of the operating characteristic curve was used to analyze the predictive value of miR-150 in the early diagnosis and prognosis of sepsis patients. Results: (1) compared with the control group, the expression level of miR-150 increased significantly (P0.01) at different time points (P0.01) and reached its peak at D2. However, the ROC curve of miR-150 for the diagnosis of sepsis had no statistical significance (P0.05); (2). The area under the curve of MMI R-150 was 0.83 cut-off value (2.88), which showed that the area under the curve was 0.83 and the sensitivity was 2.88. The specificity was 69 / 93.The AUC was lower than that of IL-6 (P0.05), but higher than that of IL-6 (P0.05) IL-6. (3) the expression level of miR-150 in septic shock group was significantly higher than that in septic group (P0.05), and was higher than that in septic group (P0.05). However, there was no significant difference between the two groups (P0.05). The SOFA score of septic shock group was higher than that of septic group (P0.05). There was a positive correlation between miR-150 and SOFA score and Apache II score at D0. (4) the level of miR-150 in survival group was significantly lower than that in death group (P0.05), and the SOFA score was significantly lower than that in death group. The ROC curve for predicting the prognosis of sepsis showed that the area under the curve of MMI R-150 was 0.77, which was lower than that of PCT (P0.05), and higher than that of AUC with IL-6 (P0.05). Conclusion: the expression of plasma miR-150 is stable and up-regulated in the course of sepsis, which may be a potential biomarker associated with the severity of sepsis. The more severe the disease, the higher the expression level of mi-R-150 has potential value in early diagnosis and prognosis prediction of sepsis.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R459.7
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