血清microRNA-25对脓毒症患者病情严重程度及预后的评估价值

Evaluation value of serum microRNA-25 on severity and prognosis of sepsis patients

目的:探究血清microRNA-25对评估脓毒症患者病情严重程度及预后的价值,分析影响脓毒症患者预后的危险因素。方法:选取82例脓毒症患者作为研究对象,根据患者病情严重程度分为脓毒症组及脓毒性休克组,30例健康体检者作为对照组。采用实时荧光定量检测方法(RT-PCR)检测血清microRNA-25表达量。记录入组患者的一般资料(性别、年龄、感染部位)和相关指标(WBC、CRP、PCT、D-D、Lac、Cys-C、SOFA评分、APACHEⅡ评分)。根据28 d预后情况分为存活组和死亡组。筛选影响脓毒症患者预后的独立危险因素,评估死亡独立危险因素对脓毒症患者死亡的预测效果。结果:①脓毒症组和脓毒性休克组间、存活组和死亡组间的性别、年龄、感染部位等差异均无统计学意义(P>0.05)。②与脓毒症组相比,脓毒性休克组患者的PCT、D-D、Lac、Cys-C、SOFA评分及APACHEⅡ评分均升高(P<0.05);③脓毒性休克组患者血清microRNA-25表达量低于脓毒症组(P<0.05);④与存活组相比,死亡组患者的PCT、D-D、Lac、Cys-C、SOFA评分及APACHEⅡ评分显著升高(P<0.05);死亡组患者microRNA-25明显低于存活组,差异有统计学意义(P<0.05)。⑤PCT、D-D、Lac、Cys-C、microRNA-25、SOFA评分、APACHEⅡ评分是脓毒症患者28 d死亡危险因素,且Lac、Cys-C、microRNA-25、SOFA评分是脓毒症患者28 d死亡的独立危险因素。结论:血清microRNA-25可作为评估脓毒症患者病情严重程度及判断预后的生物标志物;Lac、Cys-C、microRNA-25、SOFA评分是脓毒症患者28 d死亡的独立危险因素。

Objective:To explore the value of serum microRNA-25 in evaluating the severity and prognosis of sepsis patients,and analyze the risk factors affecting the prognosis of sepsis patients.Method:Eighty-two patients with sepsis were selected as the research object,and the patients were divided into sepsis group and septic shock group according to the severity of the disease.Thirty healthy subjects were used as the control group.Real-time fluorescence quantitative detection method(RT-PCR)was used to detect the expression of microRNA-25 in serum.Record the general information(sex,age,infection site)and related indicators(WBC,CRP,PCT,D-D,Lac,Cys-C,SOFA score,APACHEⅡscore)of the enrolled patients.According to the prognosis of 28 days,they were divided into survival group and death group.The independent risk factors that can affect the prognosis of sepsis patients were screened,and the predictive effect of independent risk factors for death of sepsis patients was assessed.Result:①The differences in age,gender and infection site were not statistically significant between sepsis group and septic shock group,as well as survival group and death group.②Compared with sepsis group,PCT,D-D,Lac,Cys-C,SOFA and APACHEⅡscores in septic shock group were all increased(P<0.05).③The expression of serum microRNA-25 in septic shock group was lower than that in sepsis group(P<0.05).④Compared with the survival group,PCT,D-D,Lac,Cys-C,SOFA and APACHEⅡscores of the patients in the death group were significantly higher(P<0.05);microRNA-25 in the dead group was significantly lower than that in the surviving group(P<0.05).⑤PCT,D-D,Lac,Cys-C,microRNA-25,SOFA scores and APACHEⅡscores are risk factors for 28-day death of sepsis patients,and Lac,Cys-C,microRNA-25 and SOFA scores are independent risk factors for 28-day death of sepsis patients.Conclusion:Serum microRNA-25 can be used as a biomarker to evaluate the severity and prognosis of sepsis patients.Lac,Cys-C,microRNA-25 and SOFA scores are independent risk factors for 28-day death in sepsis patients.