基于生物信息学分析miR-30a及相关炎症指标在脓毒症中的表达及临床意义

目的: 探讨 miR 30a及相关炎症指标在脓毒症中的表达并分析其临床意义。方法: 运用GEO数据库检索筛选基因芯片并分析miR-30a表达情况，采用miRecords网站数据库的预测软件预测其靶基因，并对其进行KEGG通路富集分析。收集2019年1月至2021年1月江苏大学附属医院收治的脓毒症患者64例，根据病情轻重分为脓毒症非休克组和休克组，每组32例。根据28 d 病情转归情况分为存活组（n=44）与死亡组（n=20）。另选10例健康体检者作为对照组。检测各组的白细胞（WBC）、C反应蛋白（CRP）、降钙素原（PCT）和IL 6水平，并计算序贯器官衰竭评分（SOFA）；RT-PCR检测外周血miR-30a表达，并分析与SOFA评分的相关性；应用ROC曲线评价miR 30a对脓毒症的诊断价值。结果: GEO数据库检索发现miR-30a在脓毒症组的表达高于对照组（P<0.05）。与对照组相比，脓毒症组miR-30a、WBC、CRP、PCT、IL 6及SOFA评分均升高（P＜0.05或<0.01）；与脓毒症非休克组相比，休克组WBC及SOFA评分升高（P＜0.05）；与脓毒症存活组相比，死亡组SOFA评分升高（P＜0.01）；Spearman相关性分析显示，血清miR-30a相对表达量与脓毒症SOFA评分呈正相关（r=0.751，P＜0.01），与IL-6、CRP、PCT的表达呈正相关（r=0.667、0.736、0.496, P均＜0.01）；ROC曲线评价结果显示miR-30a曲线下面积为0.831(P＜0.01)，敏感度89.1%，特异性80.0%；CRP曲线下面积为0.841(P＜0.01)，敏感度79.7%，特异性90.0%；miR-30a+CRP曲线下面积为0.902(P＜0.01)，敏感度89.1%，特异性90.0%。结论: miR 30a及相关炎症指标在脓毒症中呈高表达，其可能成为诊断脓毒症的潜在标志物。

The expression and clinical significance of miR-30 a and related inflammatory indicators in sepsis:analysis based on bioinformatics

［Abstract］Objective: To investigate the expression of miR-30a and related inflammatory indicators in sepsis and analyze its clinical significance based on bioinformatics. Methods: The gene chips were searched and screened by GEO database and their expression was analyzed. The target genes were predicted by the prediction software of miR-30a website database and KEGG pathway enrichment analysis was performed. A total of 64 sepsis patients admitted to Affiliated Hospital of Jiangsu University from January 2019 to January 2021 were collected and divided into non-shock group (n=32) and shock group (n=32) according to their severity. According to the outcome of 28 d, the sepsis patients were divided into survival group (n=44) and death group (n=20). Ten healthy subjects were selected as control group. The levels of white blood cells, C-reactive protein, procalcitonin and interleukin-6 in each group were detected, and sequential organ failure score (SOFA) were calculated. The expression of miR-30a in peripheral blood was detected by RT-PCR, and the correlation between miR 30a and SOFA score was analyzed. ROC curve was used to evaluate the diagnostic value of miR-30a in sepsis. Results:   GEO database retrieval showed that miR 30a expression in sepsis group was higher than that in control group (P<0.05). Compared with the control group, miR-30a, white blood cells, C-reactive protein, procalcitonin, interleukin-6 and SOFA scores were increased in the sepsis group(P<0.05 or <0.01). The white blood cells and SOFA scores in the shock group were higher than those in the non shock group (P<0.05). Compared with sepsis survival group, SOFA score was higher in death group(P<0.05). Spearman correlation analysis showed that the relative expression of miR 30a was positively correlated with SOFA score of sepsis (r=0.751, P<0.01) and the expressions of interleukin-6, C-reactive protein and procalcitonin (r=0.667, 0.736, 0.496, P<0.01). ROC curve evaluation results showed that the area under the curve of miR-30a was 0.831(P<0.01), the sensitivity was 89.1%, and the specificity was 80.0%; the area under the curve of C-reactive protein was 0.841(P<0.01), the sensitivity was 79.7%, the specificity was 90.0%. The area under the curve of miR 30a+C-reactive protein was 0.902(P<0.01), the sensitivity was 89.1%, and the specificity was 90.0%. Conclusion: miR 30a and related inflammatory markers are highly expressed in sepsis, which may be potential markers for the diagnosis of sepsis.