摘要
目的检测miR-22-3p、miR-324-5p在重症急性胰腺炎(SAP)患者外周血中表达情况,探讨二者与SAP患者临床病理参数的关系及在SAP相关性急性肺损伤(ALI)诊断中的应用价值。方法回顾性收集2015年2月至2017年2月确诊并治疗的86例急性胰腺炎患者为研究对象,根据是否合并ALI分为合并ALI组(n=49)和未合并ALI组(n=37)。选取同期健康体检者45例作为健康对照组。实时荧光定量PCR(qRT-PCR)检测各受试者外周血miR-22-3p、miR-324-5p水平,并计算受试者工作曲线(ROC曲线)下面积(AUC)和对SAP诊断校能,观察上述指标与临床病理参数的相关性。结果健康对照者、未合并ALI、合并ALI的SAP患者外周血miR-22-3p水平逐渐升高、miR-324-5p水平逐渐降低,两两比较差异有统计学意义(P<0.05)。检测外周血miR-22-3p、miR-324-5p水平诊断SAP疾病的AUC分别为:0.729、0.683,灵敏度分别为:57.41%、50.89%,特异度分别为:83.70%、78.61%。miR-22-3p、miR-324-5p表达与SAP患者CT分级、胸水情况、APACHEⅡ评分和是否并发ALI疾病有关(P<0.05)。miR-22-3p、miR-324-5p水平诊断SAP合并ALI疾病的AUC分别为:0.791、0.748,灵敏度分别为:63.82%、58.90%,特异度分别为:83.91%、81.71%。COX比例风险模型分析结果显示,miR-22-3p、miR-324-5p水平、CT分级是影响SAP患者ALI发生风险的独立危险因素。结论 miR-22-3p在SAP患者外周血中高表达,miR-324-5p低表达,且在合并ALI患者和未合并ALI患者中存在明显差异,检测外周血miR-22-3p、miR-324-5p水平对SAP合并ALI疾病的诊断具有一定应用价值。
Objective To detect the expressions of miR-22-3p and miR-324-5p in peripheral blood of patients with severe acute pancreatitis（ SAP） and to explore the relationships between them with the clinicopathological parameters of SAP patients and their application values in the diagnosis of SAP-related acute lung injury（ ALI）. Methods A total of 86 patients with acute pancreatitis who diagnosed and treated in our hospital from February 2015 to February 2017 were collected as the study subjects,and they were divided into combined ALI group（ n =49） and non-combined ALI group（ n = 37） according to whether ALI was combined. 45 healthy persons in the same period were selected as healthy controls. The levels of miR-22-3p and miR-324-5p in peripheral blood were measured by qRT-PCR and analyzed. The area under the receiver＇s working curve（ AUC） was calculated and diagnostic school of SAP. The correlation between the above indicators and clinical pathological parameters was observed. Results The levels of miR-22-3p in peripheral blood of healthy controls,SAP patients without ALI and SAP patients with ALI were gradually increased,and the levels of miR-324-5p were gradually decreased,and the differences were statistically significant（ P〈0. 05）. The area under the ROC curve（ AUC） in the diagnosis of SAP disease by detecting the miR-22-3p and miR-324-5p levels in peripheral blood was 0. 729,0. 683 respectively,sensitivity was 57. 41%,50. 89% respectively,and specificity was 83. 70%,78. 61%respectively. The expressions of miR-22-3 p and miR-324-5 p were associated with CT grade,hydrothorax,APACHE Ⅱ score,and the presence of ALI disease in SAP patients（ P〈0. 05）. The AUC in the diagnosis of SAP combined with ALI disease by detecting the miR-22-3 p and miR-324-5p levels was 0. 791 and 0. 748 respectively,and the sensitivities was 63. 82% and 58. 90% respectively,and the specificity was83. 91% and 81. 71% respectively. COX proportional risk model analysis showed that miR-22-3p,miR-324-5p levels,CT grade were independent risk factors affecting the risk of ALI in SAP patients. Conclusion MiR-22-3p is highly expressed in the peripheral blood of SAP patients,miR-324-5p is low expressed,and there are significant differences in patients with ALI and those without ALI. The detection of miR-22-3p and miR-324-5 p levels in peripheral blood has a certain value in the diagnosis of SAP combined with ALI.
作者
孙月玲
关万涛
邓武兴
邱玉霞
吉家聪
SUN Yue-ling;GUAN Wan-tao;DENG Wu-xing(Department of Critical Care Medicine,The Third Peolple＇s Hospital,Haikou Hainan 572000,China)
出处
《临床和实验医学杂志》
2018年第15期1599-1603,共5页
Journal of Clinical and Experimental Medicine
