脓毒症相关血清MicroRNA的筛选及其诊断价值初步研究

发布时间：2019-05-23 20:57

【摘要】：目的：本研究通过microRNA芯片技术筛选脓毒症相关血清microRNA。通过实时荧光定量PCR技术验证部分差异表达的血清microRNA，并初步探讨其对脓毒症的诊断价值。 方法：以入住呼吸重症监护病房（RICU）、急诊重症监护病房（EICU）的脓毒症病人和非脓毒症病人为研究对象。收集病人的临床资料，采集病人入选时的血清样本，脓毒症病人好转后再次采集血清样本。应用microRNA芯片技术比较3例病人脓毒症阶段和好转后血清microRNA表达水平差异，初步筛选脓毒症相关血清microRNA。扩大临床样本量至20例脓毒症病人，应用实时荧光定量PCR技术验证部分差异表达的microRNA，并比较脓毒症病人(n=95)与非脓毒症病人(n=66)所筛选出的血清microRNA表达水平的差异，初步探讨其诊断价值。 结果：（1）microRNA芯片筛选的样本为3例确诊的细菌感染的脓毒症病人的血清，比较其脓毒症阶段和好转后的血清样本，，筛选出差异表达microRNA共20个。（2）扩大样本量至20例脓毒症病人，应用实时荧光定量PCR对hsa-miR-3591-5p、hsa-miR-501-5p和hsa-let-7d-3p进行了验证，其中hsa-let-7d-3p在脓毒症阶段和治疗好转阶段有统计学差异。（3）通过比较95例脓毒症病人和66例非脓毒症病人的血清hsa-let-7d-3p水平，显示脓毒症组显著高于非脓毒症对照组。采用logistic回归校正脓毒症组与对照组在性别、年龄、白细胞计数、C反应蛋白、APACHEⅡ评分、SOFA评分、是否为创伤病人、是否接受有创机械通气、是否应用升压药物的差异后，血清hsa-let-7d-3p水平仍有统计学差异。受试者工作特征曲线（ROC）分析显示血清hsa-let-7d-3p诊断脓毒症的ROC曲线下面积为0.696(95%置信区间[0.615,0.778])。 结论：应用microRNA芯片比较病人脓毒症阶段与好转阶段的血清样本，初步筛选了脓毒症相关血清microRNA。血清hsa-let-7d-3p与脓毒症的相关性得到了荧光定量PCR的证实，血清hsa-let-7d-3p有可能作为新的脓毒症预警诊断标志物。
[Abstract]:Objective: to screen serum microRNA. related to sepsis by microRNA chip technique. Some differentially expressed serum microRNA, was verified by real-time fluorescence quantitative PCR and its diagnostic value in sepsis was preliminarily discussed. Methods: sepsis patients and non-sepsis patients admitted to respiratory intensive care unit (RICU),) emergency intensive care unit (EICU) were studied. The clinical data of the patients were collected, the serum samples were collected when the patients were selected, and the serum samples were collected again after the sepsis patients improved. MicroRNA microarray technique was used to compare the expression of microRNA in serum of 3 patients with sepsis and after improvement, and the serum microRNA. related to sepsis was screened preliminarily. The clinical sample size was expanded to 20 sepsis patients. Real-time fluorescence quantitative PCR was used to verify the partial differentially expressed microRNA, and to compare the difference of serum microRNA expression between sepsis patients (n 鈮

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