慢性阻塞性肺疾病急性加重期患者血浆miR-145miR-183表达及临床意义

Expression and clinical significance of plasma miR-145 and miR-183 in patients with acute exacerbation of chronic obstructive pulmonary disease

目的 探讨血浆miR-145及miR-183在慢性阻塞性肺疾病急性加重期(AECOPD)患者中的表达及临床意义.方法 选取2017年1月至2019年2月海南省第三人民医院呼吸科收治的AECOPD患者136例,另选取同期来我院健康体检者60例作为对照组.采用实时荧光定量PCR检测各组血浆miR-145及miR-183表达水平.应用受试者工作特征(ROC)曲线,分析血浆miR-145及miR-183表达水平对AECOPD的诊断价值.Pearson相关分析AECOPD患者血浆miR-145及miR-183表达水平与第1秒用力呼气量(FEV1)、FEV1占预计值百分比(F;EV1%)、用力肺活量(FVC)、FVC占预计值百分比(FVC%)及第1秒用力呼气量占用力肺活量的百分比(FEV1/FVC)的相关性.结果 AECOPD组血浆miR-145(4.80±1.32 vs.0.96±0.38)及miR-183(3.38±1.14 vs.0.72±0.30)表达水平均明显高于对照组(P<0.05).AECOPD组FEV1(1.20±0.26 vs.3.26±0.54,L)、FEV1% (37.80±4.20 vs.102.50±7.90)、FVC(2.56±0.24 vs.4.10±0.58, L)、FVC% (75.40±7.25 vs.105.30±9.80)及FEV1/FVC(44.60±5.18 vs.84.50±6.72)均明显低于对照组(P<0.05).ROC曲线分析显示,血浆miR-145及miR-183表达水平诊断AECOPD的最佳截断值分别为3.16、2.24,两项联合诊断AECOPD的AUC(0.892,95% CI0.840 ~0.962)最大,其敏感度和特异度为87.4%和81.5%.相关分析显示,AECOPD患者血浆miR-145及miR-183表达水平与FEV1、FEV1%、FVC、FVC%及FEV1/FVC均呈负相关(P<0.01).结论 AECOPD患者血浆miR-145及miR-183表达水平明显升高,且与AECOPD患者肺功能指标相关,两项联合检测对AECOPD诊断具有一定的临床价值.

Objective To investigate the expression and clinical significance of plasma miR-145 and miR-183 in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 136 patients with AECOPD admitted to the Third People’s Hospital of Hainan Province from January 2017 to February 2019 were selected,and another 60 healthy persons in our hospital during the same period were selected as controls.Real-time fluorescence quantitative polymerase chain reaction was used to detect the expression of plasma miR-145 and miR-183 in each group.The ROC curve was used to analyze the diagnostic value of the expression levels of miR-145 and miR-183 in plasma for AECOPD.Pearson correlation analysis was used to analyze the correlation between the expression levels of miR-145 and miR-183 in plasma of AECOPD patients and the first second forced expiratory volume(FEV1),the percentage of FEV1 to the predicted value(FEV1%),the percentage of forced vital capacity(FVC),the percentage of FVC to the predicted value(FVC%)and the percentage of the first second forced expiratory volume to the forced vital capacity(FEV1/FVC).Results The expression levels of plasma miR-145(4.80±1.32 vs.0.96±0.38)and miR-183(3.38±1.14 vs.0.72±0.30)in AECOPD group were significantly higher than those in control group(P<0.05).In AECOPD group,FEV1(1.20±0.26 vs.3.26±0.54,L),FEV1%(37.80±4.20 vs.102.50±7.90),FVC(2.56±0.24 vs.4.10±0.58,L),FVC%(75.40±7.25 vs.105.30±9.80)and FEV1/FVC(44.60±5.18 vs.84.50±6.72)were significantly lower than those in control group(P<0.05).ROC curve analysis showed that the best cut-off values for diagnosing AECOPD were 3.16 and 2.24 at the levels of plasma miR-145 and miR-183,respectively.The AUC(0.892,95%CI 0.840-0.962)for two combined diagnosis of AECOPD was the largest,with sensitivity and specificity of 87.4%and 81.5%.Relevant analysis showed that the expression levels of plasma miR-145 and miR-183 in AECOPD patients were negatively correlated with FEV1,FEV1%,FVC,FVC%and FEV1/FVC(P<0.01).Conclusion The expression levels of plasma miR-145 and miR-183 in patients with AECOPD were significantly increased,and correlated with pulmonary function in patients with AECOPD.The combined detection of the two items has certain clinical value in the diagnosis of AECOPD.