脓毒症致急性肾损伤患者miR-142-3p与PCT的关系及预测病死率的价值

The relationship between miR-142-3p and PCT in patients with sepsis induced acute renal injury and the value of predicting mortality

目的:研究脓毒症致急性肾损伤(AKI)患者miR-142-3p与降钙素原(PCT)的关系及预测病死率的价值。方法:回顾性分析2016-09—2019-03期间我院收治的脓毒症患者并分为AKI组、非AKI组,另取同期体检的健康志愿者作为对照组。检测血清miR-142-3p表达量及PCT、血尿素氮(BUN)、血肌酐(Scr)含量,随访28 d死亡情况。结果:AKI组的血清miR-142-3p表达量及PCT、BUN、Scr含量均明显高于非AKI组、对照组(P<0.05)且miR-142-3p与PCT、BUN、Scr呈正相关;AKI组中死亡患者的年龄、SOFA评分、APACHE II评分、miR-142-3p表达量及PCT含量均明显高于存活患者(P<0.05),BUN、Scr与存活患者比较无差异(P>0.05);经Logistics回归分析,年龄、SOFA评分、APACHE II评分、miR-142-3p是AKI患者28 d内死亡的独立危险因素;经ROC曲线分析,miR-142-3p预测AKI患者28 d内死亡的最佳截点为1.085,敏感度为72.73%、特异度为70.59%。结论:脓毒症致急性肾损伤患者miR-142-3p的增多与炎症反应激活、肾功能损害程度相关且对28 d死亡具有良好的预测价值。

Objective:To study the relationship between miR-142-3 p and procalcitonin(PCT)in patients with sepsis induced acute renal injury(AKI)and the value of predicting mortality.Method:The patients with sepsis admitted to our hospital from September 2016 to March 2019 were retrospectively analyzed and divided into AKI group and non AKI group.The healthy volunteers who had physical examination at the same time were selected as the control group.The expression level of serum mir-142-3 p and the contents of PCT,BUN and Scr were measured and the mortality was followed up within 28 days.Result:The expression level of serum miR-142-3 p and the contents of PCT,BUN and Scr in AKI group were significantly higher than those in non AKI group and control group(P<0.05),and miR-142-3 p was positively correlated with PCT,BUN and Scr;the age,SOFA score,APACHE II score,miR-142-3 p expression and PCT contents of death patients in AKI group were significantly higher than those of survival patients(P<0.05),BUN,Scr contents had no difference with survival patients(P>0.05);Logistic regression analysis showed that age,SOFA score and APACHE II score,miR-142-3 p were independent risk factors of AKI patients’death within 28 days.ROC curve analysis showed that the best cutoff point of miR-142-3 p for predicting AKI patients’death within 28 days was 1.085,sensitivity and specificity were72.73%and 70.59%.Conclusion:The increase of miR-142-3 p in patients with sepsis induced acute renal injury is related to the activation of inflammatory reaction and the injury of renal function,and has a good predictive value for 28 day death.