| 血浆miR-223-3p，PCT，IL-6和CRP水平联合检测对脓毒症实验诊断及预后的价值研究 |
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| 引用本文： | 王 海,肖 华,陈兴壮.血浆miR-223-3p，PCT，IL-6和CRP水平联合检测对脓毒症实验诊断及预后的价值研究[J].现代检验医学杂志,2021,0(5):51-54. |
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| 作者姓名： | 王 海 肖 华 陈兴壮 |
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| 作者单位： | （1. 三亚市中医院检验科，海南三亚 572019；2. 三亚中心医院检验科，海南三亚 572000） |
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| 摘 要： | 目的 探讨微小核糖核酸-223-3p（miR223-3p）联合降钙素原（PCT）、白细胞介素-6（IL-6）及C反应蛋白（CRP）对脓毒症诊断及预后预测的意义。方法 选取2018年1月～2020年10月三亚市中医院和三亚中心医院收治的脓毒症患者146例，根据患者28天的生存情况，将其分为存活组（n=101）和死亡组（n=45）。选取同期60例体检健康者作为对照组。检测各组血浆miR-223-3p，PCT，IL-6及CRP水平。应用受试者工作特征（ROC）曲线分析miR-223-3p联合PCT，IL-6及CRP对脓毒症诊断及预后预测的价值。结果 脓毒症组血浆miR-223-3p（2.15±0.92 vs 0.37±0.08），PCT（13.50±6.48 ng/ml vs 0.02±0.01ng/ml），IL-6（74.12±15.70 pg/ml vs 5.37±1.45pg/ml）及CRP（37.26±10.15 mg/L vs 3.82±1.46mg/L）水平均明显高于对照组，差异均有统计学意义（t=8.783~14.620，P<0.001）。死亡组血浆miR-223-3p（3.04±1.16 vs 1.31±0.50），PCT（21.28±10.28 ng/ml vs 6.72±3.15ng/ml），IL-6（102.83±21.75 pg/ml vs 56.17±10.20pg/ml）及CRP（56.40±15.30mg/L vs 25.75±8.24mg/L）水平均明显高于存活组，差异均有统计学意义（t=7.415~16.317，均P<0.001）。ROC曲线分析显示，miR-223-3p联合PCT，IL-6及CRP诊断脓毒症的曲线下面积最大（0.905，95%CI :0.847~0.968），其敏感度和特异度分别为92.0%和83.4%；miR-223-3p联合PCT，IL-6及CRP预测脓毒症患者死亡的曲线下面积最大（0.933，95%CI :0.875～0.990），其敏感度和特异度为分别95.3%和87.5%。相关性分析显示，脓毒症患者血浆miR-223-3p表达水平与PCT，IL-6及CRP均呈正相关性（r=0.825，0.792，0.753，均P<0.001）。结论 脓毒症患者血浆miR-223-3p表达水平明显升高，联合PCT，IL-6及CRP检测对脓毒症的诊断及预后预测具有良好的价值。
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| 关 键 词： | 脓毒症 微小核糖核酸-223-3p 降钙素原 白细胞介素-6 C反应蛋白 预后 |
Value of Combined Detection of Plasma miR-223-3p,PCT, IL-6 and CRPLevels in Experimental Diagnosis and Prognosis of Sepsis |
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| WANG Hai,XIAO Hua,CHEN Xing-zhuang.Value of Combined Detection of Plasma miR-223-3p,PCT, IL-6 and CRPLevels in Experimental Diagnosis and Prognosis of Sepsis[J].Journal of Modern Laboratory Medicine,2021,0(5):51-54. |
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| Authors: | WANG Hai XIAO Hua CHEN Xing-zhuang |
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| Affiliation: | （1.Department of Clinical Laboratory，Sanya Hospital of Traditional Chinese Medicine，Hainan Sanya 572000，China；2.Department of Clinical Laboratory，Sanya Central Hospital，Hainan Sanya 572000，China） |
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| Abstract: | Objective To investigate the significance of miR-223-3p combined with procalcitonin (PCT), interleukin-6 (IL-6)and C-reactive protein (CRP) in the diagnosis and prognosis of sepsis. Methods 146 patients with sepsis in Sanya Hospital ofTraditional Chinese Medicine and Sanya Central Hospital from January 2018 to October 2020 were selected and divided intosurvival group (n=101) and death group (n=45) according to their 28 days survival. At the same time, 60 healthy people wereselected as the control group. Plasma miR-223-3p, PCT, IL-6 and CRP levels were detected in each group. The value of miR-223-3p combined with PCT, IL-6 and CRP in the diagnosis and prognosis of sepsis were analyzed by ROC curve. Pearson correlationwere used to analyze the correlation between the expression of miR-223-3p and PCT, IL-6 and CRP. Results The levels of miR-223-3p (2.15±0.92 vs 0.37±0.08), PCT (13.50±6.48 ng/ml vs 0.02±0.01ng/ml), IL-6 (74.12±15.70 pg/ml vs 5.37±1.45pg/ml) and CRP (37.26±10.15 mg/L vs 3.82±1.46 mg/L) in sepsis group were significantly higher than those in control group, thedifferences were statistically significant(t=8.783~14.620，all P< 0.001). The levels of miR-223-3p (3.04±1.16 vs 1.31±0.50),PCT (21.28±10.28 ng/ml vs 6.72±3.15ng/ml), IL-6 (102.83±21.75 pg/ml vs 56.17±10.20 pg/ml) and CRP (56.40±15.30 mg/L vs25.75±8.24mg/L) in the dead group were significantly higher than those in the living group, the differences were statisticallysignificant(t=7.415~16.317，all P< 0.001). ROC curve analysis showed that the area under the curve of diagnosis of sepsis withmiR-223-3p combined with PCT, IL-6 and CRP was the largest (0.905, 95%CI: 0.847~0.968), with sensitivity of 92.0% andspecificity of 83.4%. miR-223-3p combined with PCT, IL-6 and CRP had the largest area under the curve (0.933, 95% CI:0.875~0.990) in predicting the death of patients with sepsis, with sensitivity of 95.3% and specificity of 87.5%. The correlationanalysis showed that the expression of miR-223-3p were positively correlated with PCT , IL-6 and CRP (r= 0.825, 0.792, 0.753,all P<0.001) in patients with sepsis. Conclusion The expression level of plasma miR-223-3p in sepsis patients was significantlyincreased, and the combination of PCT, IL-6 and CRP has a good value in the diagnosis and prognosis prediction of sepsis. |
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