动态监测脓毒症患者血浆miR-146a表达水平与诊断、病情评估及预后的研究
发布时间：2018-11-02 17:47
【摘要】：目的:探讨miR-146a在脓毒症诊断、病情评估及预后判断中的作用。方法:2016年2月至2017年1月在新疆某三甲医院收集54例脓毒症患者,按病情分为脓毒症组(33例)和感染性休克组(21例)。取同期健康体检者30例作为对照组。脓毒症患者按治疗前(D0)及治疗后1天(D1)、2天(D2)、3天(D3)、7天(D7)采集患者全血,检测血浆miR-146a表达水平,及血清炎症因子IL-1、IL-6、IL-10、PCT、CRP水平,并进行APACHEⅡ评分、SOFA评分。对照组检测入组时血浆miR-146a表达水平及血清IL-1、IL-6、IL-10、PCT、CRP水平。观察各指标变化趋势;分析miR-146a与IL-1、IL-6、IL-10、PCT、CRP及危重症评分之间的相关性;明确miR-146a对脓毒症诊断及预后的价值。结果:(1)脓毒症患者miR-146a、CRP随时间呈先升后降趋势,CRP于D1达高峰,miR-146a于D2达高峰;余指标呈下降趋势。(2)脓毒症患者miR-146a、IL-6、PCT、CRP表达水平在D0-D7均高于健康人;IL-1水平在D0-D3高于健康人;IL-10水平在D0、D1高于健康,D7低于健康人(P㩳0.05);余时间点两组间无差异(P㧐0.05)。(3)各指标诊断脓毒症AUC比较,PCT㧐miR-146a㧐CRP㧐IL-1㧐IL-6㧐IL-10。miR-146a的AUC为0.92(95%CI,0.87-0.98),cut-off值为14.25,敏感度、特异性分别为81.5%、90%。(4)感染性休克组miR-146a、IL-1、IL-6、PCT、CRP水平以及APACHEⅡ评分、SOFA评分在D0-D7均高于脓毒症组,感染性休克组IL-10水平在D0-D2高于脓毒症组,差异有统计学意义(P㩳0.01);余时间点两组间无差异(P㧐0.05)。(5)D0时miR-146a表达水平与SOFA评分呈正相关,与APACHEⅡ评分无明显相关性。(6)死亡组IL-1、PCT、APACHEⅡ评分、SOFA评分水平D0-D7均高于生存组;CRP水平D0-D2高于生存组,差异有统计学意义(P㩳0.05);余时间点两组间无差异(P㧐0.05);miR-146a、IL-6、IL-10水平在D0-D7两组间均无明显差异(P㧐0.05);(7)各指标预测脓毒症病死率的AUC比较,SOFA㧐PCT㧐APACHEⅡ㧐IL-1㧐CRP㧐IL-10㧐IL-6㧐miR-146a。miR-146a的AUC为0.539(95%CI,0.366-0.711)。结论:1.miR-146a在脓毒症的诊断中具有较高的价值,可能是脓毒症诊断的生物标志物。2.miR-146a对脓毒症预后判断价值较低。3.miR-146a表达水平可能与脓毒症病情严重程度有关。
[Abstract]:Objective: to investigate the role of miR-146a in the diagnosis, evaluation and prognosis of sepsis. Methods: from February 2016 to January 2017, 54 patients with sepsis were collected from a third Class A Hospital in Xinjiang. According to their condition, they were divided into sepsis group (33 cases) and septic shock group (21 cases). 30 healthy persons were taken as control group. Whole blood samples were collected from patients with sepsis before and after treatment (D1), 2 days (D2), 3 days (D3), 7 days (D7). The expression of plasma miR-146a and serum inflammatory factor IL-1,IL-6,IL-10, were detected. PCT,CRP level, and APACHE 鈪，
本文编号：2306504
[Abstract]:Objective: to investigate the role of miR-146a in the diagnosis, evaluation and prognosis of sepsis. Methods: from February 2016 to January 2017, 54 patients with sepsis were collected from a third Class A Hospital in Xinjiang. According to their condition, they were divided into sepsis group (33 cases) and septic shock group (21 cases). 30 healthy persons were taken as control group. Whole blood samples were collected from patients with sepsis before and after treatment (D1), 2 days (D2), 3 days (D3), 7 days (D7). The expression of plasma miR-146a and serum inflammatory factor IL-1,IL-6,IL-10, were detected. PCT,CRP level, and APACHE 鈪，
本文编号：2306504
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