血清miR-10a、IL-35水平对脓毒症并发急性肾损伤的诊断效能

Diagnostic efficacy of serum miR-10a and IL-35 levels in sepsis complicated with acute kidney injury

目的观察血清miR-10a、IL-35水平对脓毒症并发急性肾损伤(AKI)的诊断效能。方法脓毒症患者100例,根据是否并发AKI,分为AKI组(43例)和非AKI组(57例)。依据AKI严重程度分级标准将AKI组患者分为Ⅰ级组(23例)、Ⅱ级组(14例)、Ⅲ级组(6例)。采用PT-PCR法检测各组患者血清miR-10a,采用ELISA法检测血清IL-35。绘制受试者工作特征曲线,评价血清miR-10a、IL-35水平对脓毒血症并发AKI的诊断效能。结果AKI组患者血清miR-10a相对表达量、IL-35水平分别为3.34±0.53、(501.74±36.79)pg/mL,非AKI组分别为1.09±0.32、(269.47±28.79)pg/mL,两组相比,P均<0.001。Ⅰ级组患者血清miR-10a相对表达量、IL-35水平分别为2.98±1.06、(438.84±26.89)pg/mL,Ⅱ级组分别为4.31±1.82、(521.94±32.69)pg/mL,Ⅲ级组分别为5.89±1.98、(598.54±26.79)pg/mL,组间相比,P均<0.001。血清miR-10a水平诊断脓毒症并发AKI的曲线下面积为0.765,取截断值为3.23时,血清miR-10a水平诊断脓毒症并发AKI的敏感度为79.34%、特异度为81.23%;血清IL-35水平诊断脓毒症并发AKI的曲线下面积为0.801,取截断值为398.74 pg/mL时,血清IL-35水平诊断脓毒症并发AKI的敏感度为78.65%、特异度为82.46%;血清miR-10a联合IL-35水平诊断脓毒症并发AKI的曲线下面积为0.875,取血清miR-10a水平的截断值为3.23、血清IL-35水平的截断值为398.74 pg/mL时,诊断脓毒症并发AKI的敏感度为83.56%、特异度为88.21%。结论脓毒血症并发AKI患者血清miR-10a相对表达量、IL-35水平升高,与AKI分级有关;检测血清miR-10a、IL-35有助于脓毒症并发AKI的诊断。

Objective To observe the diagnostic efficacy of serum miR-10a and IL-35 levels in sepsis complicated with acute kidney injury(AKI).Methods Totally 100 sepsis patients were divided into the AKI group(43 cases)and non-AKI group(57 cases)according to whether or not they had concurrent AKI.According to AKI severity grading standard,patients in the AKI group were divided into grade I group(23 cases),grade II group(14 cases),and grade III group(6 cases).Serum miR-10a was detected by PT-PCR,and serum IL-35 was detected by ELISA.The working characteristic curve of subjects was drawn to evaluate the diagnostic efficacy of serum miR-10a and IL-35 levels in sepsis complicated with AKI.Results The relative expression of miR-10a and the level of IL-35 were 3.34±0.53 and(501.74±36.79)pg/mL,respectively,in the AKI group,versus 1.09±0.32 and(269.47±28.79)pg/mL,respectively,in the non-AKI group(both P<0.001).The relative expression of miR-10a and the level of IL-35 were 2.98±1.06,(438.84±26.89)pg/mL in the grade I group,4.31±1.82,(521.94±32.69)pg/mL in the grade II group,and 5.89±1.98,(598.54±26.79)pg/mL in the grade III group,respectively,with statistically significant difference(all P<0.001).The area under the curve of serum miR-10a level in diagnosing sepsis complicated with AKI was 0.765.When the cut-off value was 3.23,the sensitivity and specificity of serum miR-10a level in diagnosing sepsis complicated with AKI were 79.34%and 81.23%,respectively.The area under the curve of serum IL-35 level in diagnosing sepsis complicated with AKI was 0.801.When the cut-off value was 398.74 pg/mL,the sensitivity and specificity of serum IL-35 level in diagnosing sepsis complicated with AKI were 78.65%and 82.46%,respectively.The area under the curve of serum miR-10a combined with IL-35 for the diagnosis of sepsis complicated with AKI was 0.875.When the cut-off value of serum miR-10a and serum IL-35 was 3.23 and 398.74 pg/mL,the sensitivity and specificity for the diagnosis of sepsis complicated with AKI were 83.56%and 88.21%.Conclusions The relative expression of miR-10a and the level of IL-35 in patients with sepsis complicated with AKI increase,which is related to AKI grade.The detection of miR-10a and IL-35 in serum is helpful to the diagnosis of sepsis complicated with AKI.