miRNA-29a和miRNA-10a-5p对脓毒症所致急性肾损伤患者28 d死亡率的预测价值

发布时间：2018-02-05 23:56

本文关键词： 脓毒症 miR-a miR-a-p 急性肾损伤生存率　出处：《南方医科大学学报》2017年05期 　论文类型：期刊论文

【摘要】：目的探讨miR-29a和miR-10a-5p对评估脓毒症伴有急性肾损伤(AKI)患者28 d死亡率的预测价值。方法收集我院124例急性肾损伤患者(AKI)血清样本,分为观察组(74例脓毒症所致AKI)和对照组(脓毒症无AKI)41例,记录患者一般情况,并用RT-PCR检测其中miR-29a和miR-10a-5p的表达情况,随访28 d,记录患者生存情况,采用Pearson相关分析检验miR-29a和miR-10a-5p与观察组患者血清肌酐(Scr)、胱抑素C(Cys-C)和肾损伤分子1(KIM-1)的相关性;多因素Logistic回归分析miR-29a、miR-10a-5p、Scr、Cys-C、KIM-1以及其他危险因素与脓毒症患者28 d死亡率的相关性。ROC曲线分析比较miR-29a和miR-10a-5p与Cys-C和Scr在脓毒症患者预后评估中的价值,最后进一步用统计学方法分析miR-29a和miR-10a-5p联合与Scr及Cys-C联合对脓毒症患者预后评估的价值。结果随访28 d后:(1)74例AKI患者中21例死亡,占整体人数的35.53%;(2)相比于生存组,死亡组患者血清Scr及Cys-C表达上升(P0.05),死亡组患者血清中miR-29a和miR-10a-5p表达升高,有统计学意义(P0.05);(3)Pearson相关分析结果显示miR-29a和miR-10a-5p分别与Scr、Cys-C及KIM-1表达呈正相关;(4)多因素回归结果显示,miR-29a和miR-10a-5p均为脓毒症患者死亡的独立危险因素;(5)ROC曲线分析结果显示miR-29a和miR-10a-5p曲线下面积(au Ro C)分别为0.82(95%CI,0.71-0.89)及0.75(95%CI,0.64-0.85),Cys-C、Scr和KIM-1曲线下面积分别为0.72(95%CI,0.66-0.86)、0.71(95%CI,0.63-0.84)及0.81(95%CI,0.72-0.81)。miR-29a及miR-10a-5p二者联合检测的au ROC值优于单一检测miR-29a、miR-10a-5p、Cys-C、Scr和KIM-1(P0.05)。结论 miR-29a和miR-10a-5p在评估脓毒症患者死亡率时具有良好的预测价值。
[Abstract]:Objective to investigate the value of miR-29a and miR-10a-5p in the evaluation of sepsis with acute renal injury. Methods Serum samples of 124 patients with acute renal injury were collected. The patients were divided into observation group (n = 74) and control group (n = 74) and control group (n = 74). The expression of miR-29a and miR-10a-5p was detected by RT-PCR, followed up for 28 days, and the survival of the patients was recorded. Pearson correlation analysis was used to examine the relationship between miR-29a and miR-10a-5p and creatinine creatinine (creatinine) in the observation group. The correlation between cystatin Con Cys-Cand renal injury molecule 1 (KIM-1); Multivariate Logistic regression analysis of miR-29a1 miR-10a-5pScr-C was performed. KIM-1 and other risk factors in patients with sepsis. D the value of miR-29a, miR-10a-5p, Cys-C and Scr in evaluating the prognosis of sepsis patients was compared with that of miR-29a and miR-10a-5p by .ROC curve analysis. Finally, the value of miR-29a and miR-10a-5p combined with Scr and Cys-C in evaluating the prognosis of sepsis patients was analyzed by statistical method. 1 among 74 AKI patients, 21 died. 35.53% of the total population; (2) compared with the survival group, the expression of Scr and Cys-C in the serum of the patients with death was higher than that of the patients with death, and the expression of miR-29a and miR-10a-5p in the serum of the patients with death was higher than that of the patients with death. There was statistical significance (P 0.05). Pearson correlation analysis showed that miR-29a and miR-10a-5p were positively correlated with the expression of Cys-C and KIM-1, respectively. Multivariate regression analysis showed that both miR-29a and miR-10a-5p were independent risk factors for death in sepsis patients. The results of ROC curve analysis showed that the area under the miR-29a and miR-10a-5p curves was 0.82% 95 CI, respectively. The area under the Cys-CU SCR and KIM-1 curves was 0.72c95CI. 0.66-0.86 ~ 0.71 ~ (95) CI = 0.63-0.84) and 0.81 ~ (95) CI. The au ROC value of the combined detection of 0.72-0.81g 路miR-29a and miR-10a-5p was better than that of miR-29a / miR-10a-5p detected by single detection. Conclusion miR-29a and miR-10a-5p have a good predictive value in evaluating the mortality of sepsis patients.
【作者单位】：重庆市中医院重症医学科;
【分类号】：R459.7;R692

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