血清miR-29及miR-150对急性肾损伤患者预后的预测价值

Prognostic value of serum miR - 29 and miR - 150 in patients with acute renal injury

目的 探讨血清miR-29及miR-150对急性肾损伤（AKI）患者预后的预测价值。方法 选取2016-01-2017-12海南省第三人民医院收治的AKI患者126例，根据其28 d的生存情况分为存活组（82例）和死亡组（44例），按AKI分期标准分为AKI 1期（57例）、AKI 2期（40例）、AKI 3期（29例）。采用RT-PCR检测各组血清miR-29及miR-150表达水平，并记录AKI患者确诊时APACHEⅡ评分。应用受试者工作特征（ROC）曲线分析miR-29及miR-150对AKI患者预后评估的价值。采用Pearson相关分析评价AKI患者血清miR-29、miR-150水平与APACHEⅡ评分的相关性。结果死亡组血清miR-29（3.14±0.96 vs. 1.93±0.42）及miR-150（4.26±1.18 vs. 2.05±0.48）表达水平明显高于存活组（t=10.703、15.106，P＜0.001）。AKI 3期血清miR-29（3.34±1.08 vs. 2.19±0.61和1.85±0.34）及miR-150（3.92±1.15 vs. 2.80±0.91和2.55±0.84）表达水平明显高于AKI 2期和AKI 1期（F=5.124、7.825，P＜0.05）。ROC曲线显示，血清miR-29及miR-150预测AKI预后的最佳截断值分别为2.74、3.83，二者联合［AUC（95%CI）：0.918（0.852～0.974）］预测AKI预后的敏感度和特异度较好，分别为93.6%和86.5%。相关分析显示，miR-29水平与miR-150水平呈正相关（r=0.806，P＜0.01），miR-29、miR-150水平与APACHEⅡ评分均呈正相关（r=0.634、r=0.702，P＜0.01）。结论血清miR-29及miR-150表达水平与AKI患者病情严重程度相关，可能成为AKI治疗和预后判断的新靶点。

Objective To evaluate the prognostic value of serum miR - 29 and miR - 150 in patients with acute renal injury （AKI）. Methods One hundred and twenty -six cases of AKI patients admitted to the Third People＇s Hospital of Hainan Province from January 2016 to December 2017, according to the survival of the 28 days were divided into the survival group （82 cases） and death group （44 cases）. According to the standard of AKI staging, it was divided into AKI 1 （57 cases）, AKI 2 （40 cases） and AKI 3 （29 cases）. The serum levels of miR -29 and miR -150 were detected by RT- PCR, and the APACHE Ⅱ score of AKI patients was recorded. The value of miR -29 and miR - 150 for evaluating the prognosis of AKI patients was analyzed by the ROC curve. Correlation analysis of serum miR - 29, miR - 150 level and APACHE Ⅱ score in AKI patients was done with Pearson correlation analysis. Results The expression level of miR - 29 （3.14 ± 0.96 vs. 1.93 ± 0.42） and miR- 150 （4.26 ±1.18 vs. 2.05 ± 0.48 ） in the death group was significantly higher than that in the survival group （t = 10. 703, 15. 106, P 〈0. 001 ）. Serum miR -29 （3.34 ± 1.08 vs. 2.19 ±0.61 and 1.85±0.34） and miR - 150 （3.92± 1.15 vs. 2.80±0.91 and 2.55 ±0.84） expression level in AKI phase 3 were significantly higher than those in AKI phase 2 and AKI phase 1 （ F = 5. 124, 7. 825, P 〈 0.05）. The ROC curve showed that the best cutoff value of serum miR- 29 and miR- 150 in predicting the prognosis of AKI were 2.74 and 3.83, respectively. The two combination of miR - 29 and miR- 150 [ AUC （95% CI）： 0. 918 （0. 852 - 0. 974）] had better sensitivity and specificity in predicting AKI the prognosis of AKI were 93.6% and 86.5% , respectively. Correlation analysis showed that miR - 29 level was positively correlated with miR - 150 level （ r = 0. 806, P 〈 0.01 ）, miR - 29 and miR- 150 levels were positively correlated with APACHE Ⅱ score （r = 0. 634, r = 0. 702, P 〈 0.01 ）. Conclusion The expression level of serum miR - 29 and miR - 150 is related to the severity of patients with AKI, and may be a new target for the treatment of AKI and the prognosis of the patients.