脓毒症患者外周血miR-326与miR-370-3p表达及其意义

目的探究脓毒症患者外周血miR-326、miR-370-3p的表达及其意义。方法选取2018年9月-2020年9月唐山市工人医院收治的94例脓毒症患者为研究组,同时募集同期体检健康者45名为对照组,脓毒症患者根据病情严重程度分为无休克组(n=62)和休克组(n=32),根据治疗28 d转归情况分为存活患者(n=70)和死亡患者(n=24);采用实时荧光定量聚合酶链式反应(qRT-PCR)检测外周血miR-326、miR-370-3p的表达,比较各组患者miR-326、miR-370-3p表达。结果脓毒症患者心率(HR)、外周血miR-326、miR-370-3p分别为(116.52±10.48)次/min、3.41±0.59、2.45±0.47高于对照组(P<0.001),miR-326、miR-370-3p单独及联合诊断脓毒症的AUC分别为0.822(95%CI:0.746~0.899)、0.784(95%CI:0.694~0.875)、0.881(95%CI:0.822~0.940)。无休克组HR、外周血miR-326、miR-370-3p、PCT、急性生理学与慢性健康评分系统(APACHE)Ⅱ评分、序贯器官衰竭评分(SOFA)分别为(114.26±12.52)次/min、3.19±0.47、2.23±0.54、(21.45±4.89)ng/L、(17.84±2.45)分及(6.71±0.84)分低于休克组(P<0.001),存活患者外周血miR-326、miR-370-3p、PCT、APACHEⅡ评分及SOFA评分分别为2.95±0.42、2.11±0.38、(24.58±3.76)ng/L、(16.27±3.68)分及(6.23±0.95)分低于死亡组(P<0.001);脓毒症患者外周血miR-326、miR-370-3p分别与APACHEⅡ评分、SOFA评分呈正相关(P<0.001)。结论 miR-326、miR-370-3p在脓毒症患者异常升高,可能作为脓毒症的早期诊断标志物,并与患者病情及预后密切相关。

Expression of miR-326 and miR-370-3p in peripheral blood of sepsis patients and their significance

OBJECTIVE To explore the expression and significance of miR-326 and miR-370-3 p in peripheral blood of sepsis patients. METHODS A total of 94 sepsis patients admitted to Tangshan Workers′ Hospital from Sep. 2018 to Sep. 2020 were selected as the research group, and 45 healthy people who had physical examinations during the same period were enrolled as control group. Patients with sepsis were divided into non-shock group(n=62) and shock group(n=32) according to the severity of their illness, and were divided into survival group(n=70) and death group(n=24) according to the outcomes after 28 d of treatment. The expression of miR-326 and miR-370-3 p in peripheral blood was detected by real-time fluorescent quantitative PCR(qRT-PCR), and the expression of miR-326 and miR-370-3 p in different groups was compared. RESULTS The heart rate(HR), peripheral blood miR-326 and miR-370-3 p of patients with sepsis were(116.52±10.48) times/min,(3.41±0.59) and(2.45±0.47), respectively, significantly higher than those of the control group(P<0.001). The AUC values of miR-326, miR-370-3 p alone and in the combination for diagnosis of sepsis were 0.822(95%CI: 0.746-0.899), 0.784(95%CI: 0.694-0.875) and 0.881(95%CI: 0.822-0.940), respectively. HR, peripheral blood miR-326 and miR-370-3 p, PCT, scores of acute physiology and chronic health evaluation(APACHE) II and sequential organ failure assessment(SOFA) in non-shock group were(114.26±12.52) times/min,(3.19±0.47),(2.23±0.54),(21.45±4.89) ng/L,(17.84±2.45) points and(6.71±0.84) points, respectively, significantly lower than those in shock group(P<0.05). The peripheral blood miR-326 and miR-370-3 p, PCT, scores of APACHE II and SOFA of survival group were(2.95±0.42),(2.11±0.38),(24.58±3.76) ng/L,(16.27±3.68) points and(6.23±0.95) points, respectively, significantly lower than those of death group(P<0.001). Peripheral blood miR-326 and miR-370-3 p of sepsis patients were positively correlated with scores of APACHE II and SOFA, respectivley(P<0.001). CONCLUSION The miR-326 and miR-370-3 p are abnormally elevated in sepsis patients, which may be the early diagnostic markers of sepsis, and are closely related to their conditions and prognosis.