摘要
目的 探究脓毒症并发急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者血清微小核糖核酸-181-5p(miR-181-5p)、微小核糖核酸-21-3p(miR-21-3p)、微小核糖核酸-124-3p(miR-124-3p)对其的预测价值。方法 选取2023年3月至2024年3月南阳市中心医院收治的184例脓毒症患者,根据脓毒症患者入院72 h内是否发生ARDS分为ARDS组60例和非ARDS组124例。采用实时荧光定量PCR(qRT-PCR)法检测血清miR-181-5p、miR-21-3p、miR-124-3p水平。受试者工作特征(ROC)曲线分析血清miR-181-5p、miR-21-3p、miR-124-3p对脓毒症患者并发ARDS的预测价值。多因素logistic回归分析(enter法筛选变量)脓毒症患者并发ARDS的影响因素。结果 与非ARDS组相比,ARDS组APACHEⅡ评分[(18.15±2.64)分vs.(12.05±2.41)分]、C反应蛋白(CRP)[(16.22±2.14)mg/L vs.(14.02±2.07)mg/L]、降钙素原(PCT)[(3.84±0.58)ng/mL vs.(2.97±0.42)ng/mL]水平均显著升高(P<0.05),血清中miR-181-5p(0.85±0.14 vs.1.02±0.15)、miR-21-3p(0.87±0.15 vs.1.03±0.14)、miR-124-3p(0.86±0.14 vs.1.01±0.12)水平均显著降低(P<0.05)。血清miR-181-5p、miR-21-3p、miR-124-3p水平联合对脓毒症患者并发ARDS预测的ROC曲线下面积(AUC)显著高于单独预测(Z=4.893、3.831、4.608,P<0.001)。多因素logistic回归分析显示,APACHEⅡ评分(OR=2.547)、miR-181-5p(OR=0.625)、miR-21-3p(OR=0.755)、miR-124-3p(OR=0.725)为影响脓毒症患者并发ARDS的影响因素(P<0.05)。结论 脓毒症并发ARDS患者血清中miR-181-5p、miR-21-3p、miR-124-3p水平均低表达,三者对脓毒症患者并发ARDS有一定的预测价值。
Objective To explore the predictive value of serum miR-181-5p,miR-21-3p,and miR-124-3p in sepsis patients complicated by acute respiratory distress syndrome(ARDS).Methods A total of 184 sepsis patients admitted to Nanyang Central Hospital between March 2023 and March 2024 were selected.Based on whether ARDS occurred within 72 hours of hospital admission,the patients were divided into an ARDS group(60 patients)and a non-ARDS group(124 patients).Serum levels of miR-181-5p,miR-21-3p,and miR-124-3p were measured using real-time quantitative PCR(qRT-PCR).Receiver operating characteristic(ROC)curves were used to assess the predictive value of these microRNAs for ARDS in sepsis patients.Multivariate logistic regression analysis(using the enter method to screen variables)was performed to analyze the factors influencing the occurrence of ARDS in sepsis patients.Results Compared with the non-ARDS group,the ARDS group had significantly higher APACHEⅡscores(18.15±2.64 vs.12.05±2.41),CRP[(16.22±2.14)mg/L vs.(14.02±2.07)mg/L],and PCT[(3.84±0.58)ng/mL vs.(2.97±0.42)ng/mL](P<0.05).The serum levels of miR-181-5p(0.85±0.14 vs.1.02±0.15),miR-21-3p(0.87±0.15 vs.1.03±0.14),and miR-124-3p(0.86±0.14 vs.1.01±0.12)were significantly lower in the ARDS group compared to the non-ARDS group(P<0.05).The combination of serum miR-181-5p,miR-21-3p,and miR-124-3p levels had a significantly higher area under the ROC curve(AUC)for predicting ARDS in sepsis patients than when each was assessed separately(Z=4.893,3.831,4.608,P<0.001).Multivariate logistic regression analysis showed that APACHEⅡscore(ODepartment of Respiratory and Critical Care Medicine,Nanyang Central Hospital,Nanyang 473000,Henan,China R=2.547),miR-181-5p(OR=0.625),miR-21-3p(OR=0.755),and miR-124-3p(OR=0.725)were significant factors influencing the occurrence of ARDS in sepsis patients(P<0.05).Conclusion In sepsis patients complicated by ARDS,serum miR-181-5p,miR-21-3p,and miR-124-3p levels are downregulated.The combination of these three microRNAs has significant predictive value for the development of ARDS in sepsis patients.
作者
金博
崔勇俊
韩彬
曲伟伟
李博
JIN Bo;CUI Yong-jun;HAN Bin;QU Wei-wei;LI Bo(Department of Respiratory and Critical Care Medicine,Nanyang Central Hospital,Nanyang 473000,Henan,China)
出处
《广东医学》
2025年第4期565-569,共5页
Guangdong Medical Journal
基金
河南省医学科技攻关(联合共建)项目(LHGJ202103045)。
