miR-223与脓毒症炎性反应的相关性

Correlation between miR-223 and inflammatory reaction in sepsis

目的探讨miR-223与脓毒症炎性反应的相关性及临床意义。方法187例脓毒症患者,根据28 d生存情况分为生存组132例和死亡组55例,采用实时荧光定量PCR法检测2组患者血浆miR-223相对表达量,采用ELISA法检测2组患者血清C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子(tumor necrosis factor,TNF)-α、白细胞介素(interleukin,IL)-1β、IL-6、IL-8、IL-10水平;采用Spearman相关分析脓毒症患者血浆miR-223相对表达量与急性生理学和慢性健康(Acute Physiology and Chronic Health Evaluation Scoring System,APACHE)Ⅱ评分及血清CRP、TNF-α、IL-1β、-6、-8、-10水平的相关性;绘制ROC曲线,评估血浆miR-223相对表达量预测脓毒症患者存活的效能。结果死亡组患者血浆miR-223相对表达量[4.898(2.591,7.327)]明显高于生存组[2.727(1.043,4.017)](P<0.05);死亡组患者血清CRP、TNF-α、IL-1β、IL-6、IL-8和IL-10水平高于生存组(P<0.05);脓毒症患者血浆miR-223相对表达量与APCHEⅡ评分(r=0.459,P<0.001)、CRP(r=0.326,P<0.001)、TNF-α(r=0.325,P<0.001)、IL-1β(r=0.165,P=0.024)、IL-6(r=0.229,P=0.002)和IL-8(r=0.154,P=0.035)均呈正相关,与IL-10呈负相关(r=-0.289,P<0.001);血浆miR-223相对表达量最佳截断值为3.975时,预测脓毒症患者存活的AUC为0.600(95%CI:0.505~0.695),灵敏度为83.5%,特异度为38.9%。结论血浆miR-223相对表达量与脓毒症患者病情严重程度及炎性反应明显相关,可作为判断脓毒症预后的生物标志物之一。

Objective To investigate the correlation between plasma miR-223 and inflammatory markers in sepsis patients and its clinical significance.Methods Totally 187 sepsis patients were divided into survival group(n=132)and death group(n=55)according to the 28-day survival.The relative expression of plasma miR-223 was detected by real-time fluorescence quantitative PCR(RT-PCR).ELISA was used to detect the levels of serum C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin(IL)-1β,IL-6,IL-8 and IL-10.Spearman correlation was used to analyze the correlation of the relative expression of plasma miR-223 with APCHEⅡscore,CRP,TNF-α,IL-1β,IL-6,IL-8 and IL-10 in sepsis patients.ROC was used to evaluate the efficiency of the relative expression of plasma miR-223 on predicting the survival of patients with sepsis.Results The relative expression of miR-223 was higher in death group(4.898(2.591,7.327))than that in survival group(2.727(1.043,4.017))(P<0.05).The levels of CRP,TNF-α,IL-1β,IL-6,IL-8 and IL-10 were higher in death group than those in survival group(P<0.05).The relative expression of miR-223 was positively correlated with APCHEⅡscore(r=0.459,P<0.001),CRP(r=0.326,P<0.001),TNF-α(r=0.325,P<0.001),IL-1β(r=0.165,P=0.024),IL-6(r=0.229,P=0.002)and IL-8(r=0.154,P=0.035),and negatively correlated with IL-10(r=-0.289,P<0.001).When the optimal cut-off of miR-223 was 3.975,the AUC for predicting the survival was 0.600(95%CI:0.505-0.695),with a sensitivity and specificity of 83.5%and 38.9%.Conclusion The relative expression of plasma miR-223 is obviously correlated with the disease severity and inflammatory reaction,and it might be served as a novel prognostic biomarker for sepsis.