miR-21预测心脏介入术后急性肾损伤及其它不良结果发生风险的临床研究

Clinical study of miR-21 in predicting the risk of acute renal injury and other adverse outcomes after cardiac surgery

目的探讨微小RNAs-21（miR-21）对心脏介入术后急性肾损伤（AKI）及其它不良结果的预测效果,为AKI的早期诊断提供参考依据。方法选择2013年5月至2015年5月收治的89例介入手术患者做为研究对象,根据术后有无AKI分为AKI组（n=26）和非AKI组（n=63）。比较两组患者的血清miR-21水平以及肾脏替代治疗、死亡、感染等不良结果发生率。并通过受试者工作特征曲线（ROC）分析miR-21的诊断价值。结果 AKI组肾脏替代治疗、病死率及ICU停留时间、住院时间均高于非AKI组,差异有统计学意义（P〈0.05）;AKI组血清miR-2相对表达量（16.44±7.54）显著高于非AKI组（3.87±1.25）,差异有统计学意义（P〈0.05）;miR-21诊断AKI的ROC曲线图下面积为0.846（95%CI 0.747~0.945）（P〈0.05）。结论在心脏介入术后AKI患者中血清miR-21水平显著升高,血清miR-21水平对AKI及其它不良结果的发生具有较好的预测价值,可作为心脏介入手术患者短期预后的重要标志物。

Objective To investigate the clinical study of miR-21 in predicting the risk of acute renal injury（AKI） and other adverse outcomes after cardiac surgery,to provide the reference for the early diagnosis of AKI.Methods From May 2013 to May 2015,89 cases of patients with cardiac surgery treated in our hospital were selected as the research objects,according to the occurrence of AKI after operation,the patients were divided into AKI group（n = 26） and non AKI group（n = 63）.The levels of serum miR-21,renal replacement therapy,death,and infection were compared between the two groups.And the diagnostic value of miR-21 was analyzed by the receiver operating characteristic curve（ROC）.Results The renal replacement therapy,death ratio and ICU residence time and hospitalization time in AKI group were higher than those of the non AKI group（P〈0.05）.The relative expression of miR-21 in AKI group was（16.44±7.54）,were significantly higher than（3.87±1.25） that in the non AKI group（P〈0.05）.The area under the ROC curve of miR-21 was 0.846（95 % CI 0.747 ~ 0.945,P〈0.05）.Conclusion The serum level of miR-21 was significantly increased in patients with AKI after cardiac surgery.It has good predictive value for AKI and other adverse outcomes,which can be used as an important marker for short-term prognosis of cardiac surgery patients.