摘要
目的:探讨连续性肾脏替代治疗(CRRT)对脓毒症患者外周血微小RNA(miRNA)-155和miRNA-466表达的影响。方法:80例脓毒症患者分为观察组(42例)和对照组(38例),对照组采用对症、抗炎、抑菌及补液等治疗,观察组在对照组治疗基础上加用CRRT;比较治疗前及治疗4周时2组患者的急性生理与慢性健康(APACHEⅡ)评分、全身性感染相关性器官功能衰竭(SOFA)评分、外周血T淋巴细胞CD4^+、CD8^+、CD14^+单核细胞人类白细胞抗原DR(CD14^+HLA-DR)、血清降钙素原(PCT)、白细胞介素-23(IL-23)、C反应蛋白(CRP)、miRNA-155及miRNA-466表达水平。结果:治疗前,2组患者上述指标比较,差异无统计学意义(P>0.05);2组患者治疗4周时的APACHEⅡ评分、SOFA评分,血清PCT、IL-23及CRP水平较治疗前显著降低(P<0.05),观察组患者降低更显著(P<0.05);2组患者治疗4周时外周血CD4^+T淋巴细胞、CD8^+T淋巴细胞、DRHLA-DR百分比较治疗前显著升高(P<0.05),观察组患者升高更显著,差异有统计学意义(P<0.05)。结论:CRRT可调控CD4^+、CD14^+HLA-DR、CD8^+水平,减轻PCT、IL-23、CRP炎症因子与miRNA-155和miRNA-466表达。
Objective:To analyze the effect of continuous renal replacement therapy on the expression of miRNA-155 and miRNA-466 in peripheral blood of patients with sepsis.Methods:Eighty patients with sepsis in our hospital from February 2018 to February 2019 were enrolled and divided into the observation group(42 cases)and the control group(38 cases)by the random sampling method.The control group was treated with symptomatic treatment,anti-inflammatory,antibacterial,and fluid infusion treatments,while the observation group received continuous renal replacement therapy in addition to the treatment for the control group.The Acute Physiology and Chronic Health Evaluation(APACHE II score)and Sepsis-related Organ Failure Assessment(SOFA)score changes,peripheral blood immune markers(T lymphocytes(CD4^+,CD8^+),CD14^+monocytes human leukocyte antigen DR(CD14^+HLA-DR),inflammatory factor levels(procalcitonin)(PCT),interleukin-23(IL-23),C-reactive protein(CRP),miRNA-155 and miRNA-466 expression were observed and recorded before treatment and after 1 course of treatment.Results:Four weeks after treatment,APACHE II and SOFA scores showed reduced PCT,IL-23 and CRP,miRNA-155 and miRNA-466 expression,more obviously in the observation group than in the control group(P<0.05),while CD4^+T lymphocytes and CD14^+,HLA-DR CD14^+monocytes HLA-DR,and CD8^+T lymphocytes in the observation group increased more significantly than those in the control group(P<0.05).Conclusions:Continuous renal replacement therapy can control the CD4^+,CD14^+HLA-DR and CD8^+levels,and reduce PCT,IL-23,CRP inflammatory factors as well as miRNA-155 and miRNA-466 expressions.
作者
郑燕玲
张应魏
邓小彦
ZHENG Yanling;ZHANG Yingwei;DENG Xiaoping(Department of Critical Care Medicine,the First Affiliated Hospital of Hainan Medical University,Haikou 570000,Hainan,China;Department of Neurology,Hainan Provincial Geriatrics Hospital,Haikou 571100,Hainan,China)
出处
《贵州医科大学学报》
CAS
2020年第4期451-455,460,共6页
Journal of Guizhou Medical University
基金
国家自然科学基金(81760341)。
