血清微小RNA-325-3p和成纤维细胞生长因子10表达水平对急性胰腺炎病情及预后评估的价值

The value of serum miR-325-3p and fibroblast growth factor 10 expression levels in evaluating the condition and prognosis of patients with acute pancreatitis

目的 探讨急性胰腺炎血清微小RNA-325-3p(miR-325-3p)和成纤维细胞生长因子10(FGF10)表达水平对病情严重程度及预后的评估价值。方法 2021年6月~2022年10月我院诊治的急性胰腺炎病人265例,分为轻症急性胰腺炎组(100例)、中重症急性胰腺炎组(70例)和重症急性胰腺炎组(95例);同期260例健康体检志愿者为对照A组,260例慢性胰腺炎病人为对照B组。根据重症病人入院28天的生存情况,将病人分为生存组(68例)和死亡组(27例)。比较各组病人miR-325-3p和FGF10水平。分析急性胰腺炎病人血清miR-325-3p、FGF10水平与急性生理和慢性健康评分Ⅱ(APACHEⅡ)评分的相关性以及miR-325-3p与FGF10的相关性;对影响重症急性胰腺炎病人预后的因素进行Logistic回归分析;受试者工作特征(ROC)曲线分析血清miR-325-3p、FGF10水平对重症急性胰腺炎病人预后的预测价值。结果 与对照A、B组相比,轻症、中重症、重症急性胰腺炎组病人血清miR-325-3p水平依次显著降低,差异有统计学意义(P<0.05),FGF10水平依次明显升高,差异有统计学意义(P<0.05);急性胰腺炎病人血清miR-325-3p与FGF10水平、APACHEⅡ评分均呈负相关(APACHEⅡ:r=-0.664,P<0.05;FGF10:r=-0.687,P<0.05)。FGF10与APACHEⅡ评分呈正相关(r=0.676,P<0.05)。与生存组相比,死亡组身体质量指数(BMI)、APACHEⅡ评分、FGF10水平均明显升高(P<0.05),miR-325-3p水平显著降低,差异有统计学意义(P<0.05);Logistic回归分析发现,BMI、APACHEⅡ评分、FGF10是影响重症急性胰腺炎病人预后的危险因素(P<0.05),miR-325-3p是影响重症病人预后的保护因素(P<0.05);miR-325-3p、FGF10联合预测重症急性胰腺炎病人预后的ROC曲线下面积(AUC)为0.972,均优于其各自单独预测(Z二者联合-miR-325-3P=1.984,P=0.047;Z二者联合-FGF10=2.219,P=0.027)。结论 急性胰腺炎病人血清miR-325-3p水平降低,FGF10水平升高,与病人病情严重程度及预后相关。

Objective To investigate the value of the expression levels of serum microRNA-325-3p(miR-325-3p)and fibroblast growth factor 10(FGF10)in evaluating the severity and prognosis of acute pancreatitis.Methods A total of 265 patients with acute pancreatitis diagnosed and treated in our hospital from June 2021 to October 2022 were selected as the observation group,the patients were divided into mild acute pancreatitis group(100 cases),moderate severe acute pancreatitis group(70 cases)and severe acute pancreatitis group(95 cases)according to clinical severity;in the same period,260 healthy volunteers served as the control group A,and 260 patients with chronic pancreatitis as control group B.According to 28 d survival condition,the severe patients were divided into survival group(n=68)and death group(n=27).To compare miR-325-3p and FGF10 levels in each group of patients.Analysis of the correlation between serum miR-325-3p,FGF10 levels and Acute Physiology and Chronic Health EvaluationⅡscore and the correlation between serum miR-325-3p and FGF10 in patients with acute pancreatitis;Logistic regression analysis was used to analyze the factors affecting the prognosis of patients with severe acute pancreatitis;the prognostic value of serum miR-325-3p and FGF10 levels in patients with severe acute pancreatitis was analyzed by ROC curve.Results Compared with the control group A and B,the level of miR-325-3p in serum of patients with mild,moderate and severe acute pancreatitis decreased obviously in turn(P<0.05),and the levels of FGF10 increased obviously in turn(P<0.05);serum miR-325-3p in patients with acute pancreatitis was negatively correlated with FGF10 level and APACHEⅡscore(APACHEⅡ:r=-0.664,P<0.05;FGF10:r=-0.687,P<0.05),and FGF10 was positively correlated with APACHEⅡscore(r=0.676,P<0.05).Compared with the survival group,the body mass index,APACHEⅡscore and FGF10 level in the death group were obviously higher(P<0.05),and the miR-325-3p level was obviously lower(P<0.05);Logistic regression analysis showed that body mass index,APACHEⅡscore and FGF10 were risk factors affecting the prognosis of patients with severe acute pancreatitis(P<0.05),miR-325-3p was a protective factor affecting the prognosis of patients(P<0.05);the area under the ROC curve(AUC)of miR-325-3p combined with FGF10 to predict the prognosis of patients with severe acute pancreatitis was 0.972,which was better than their individual prediction(Z combination-miR-325-3P=1.984,P=0.047;Z combination-FGF10=2.219,P=0.027).Conclusion The level of serum miR-325-3p in patients with acute pancreatitis decreases,and the level of FGF10 increases,they are related to the severity and prognosis of patients,and have certain value in evaluating the prognosis of patients.