高脂血症性急性胰腺炎患者血清miR-345-5p的表达及意义

Expression and significance of miR-345-5p in serum of patients with hyperlipidemic acute pancreatitis

目的探讨高脂血症性急性胰腺炎(HTGAP)患者外周血miR-345-5p的表达水平及其临床意义。方法选取2017年12月-2018年9月西部战区总医院普通外科中心收治的HTGAP患者40例(A组)、非HTGAP患者75例(B组),同时选取高脂血症非急性胰腺炎患者25例(C组)和健康志愿者30例(D组)为对照组。其中A组根据急性胰腺炎亚特兰大分级标准再分为轻度(HTG-MAP)与重度(HTG-SAP)两个亚组,每组20例。检查所有患者血清三酰甘油和淀粉酶水平并进行APACHEⅡ评分,应用实时荧光定量PCR检测血清中miR-345-5p的表达水平,分析miR-345-5p表达水平与HTGAP临床指标的相关性,并评估其在预测急性胰腺炎严重程度中的作用。结果 A组患者血清中miR-345-5p的表达水平(2.28±0.23)明显高于B组(0.35±0.21)、C组(0.29±0.23)和D组(0.25±0.33),差异均有统计学意义(P<0.001),而B、C、D组之间miR-345-5p的表达差异无统计学意义。ROC曲线分析显示miR-345-5p检测HTG-SAP的曲线下面积为0.785(0.634～0.935)。重度HTGAP组miR-345-5p的表达水平(2.95±0.46)明显高于轻度HTGAP组(0.69±0.23),差异有统计学意义(P<0.05);miR-345-5p表达水平与三酰甘油水平具有相关性(r=0.853,P<0.001),而与淀粉酶无相关性(r=–0.239,P>0.05)。结论 miR-345-5p在HTGAP中表达明显上调,且其随着病情严重程度而升高,有望为HTGAP的临床诊断及严重程度评估提供新的途径。

Objective To investigate the expression of miR-345-5p in peripheral blood of patients with hyperlipidemic acute pancreatitis(HAP)and its clinical significance.Methods From December 2017 to September 2018,40 patients with HAP(group A)and 75 patients with non-HAP(group B)admitted to the general surgery center of the General Hospital of Western Theater Command were enrolled.25 patiens with hyperlipidemic non-acute pancreatitis patients(group C)and 30 healthy volunteers(group D)were selected as the control group.Group A was subdivided into H-MAP group and H-SAP group.All the patients were examined for serum triacylglycerol and amylase biochemical levels,and scored on the APACHEⅡ.The expression level of miR-345-5p in serum was detected by real-time fluorescent quantitative PCR.The relationship between miR-345-5p expression level and clinical indicators of HAP was analyzed and the role of miR-345-5p in predicting the severity of acute pancreatitis evaluated.Results The expression level of miR-345-5p in serum of group A(2.28±0.23)was significantly higher than that of groups B(0.35±0.21),C(0.29±0.23)and D(0.25±0.33).The difference was statistically significant(P<0.001).But there was no significant difference in expression of miR-345-5p between groups B,C and D(P>0.05).The ROC curve analysis showed that the area under the curve of miR-345-5p detection H-SAP was 0.785(0.634~0.935).The expression of miR-345-5p in the HAP severe group(2.95±0.46)was significantly higher than that in the mild HAP group(0.69±0.23),the difference was statistically significant(P<0.05).The expression level of miR-345-5p was correlated with triacylglycerol level(r=0853,P<0.001),but not correlated with amylase(r=–0.239,P>0.05).Conclusion The serum miR-345-5p is significantly up-regulated in HAP,and it increases with the severity of the disease,which may provide a new way for the clinical diagnosis and severity assessment of HAP.