慢性阻塞性肺疾病急性加重期患者血清microRNA-146a水平及其临床意义

Serum level of miRNA-146a in patients with acute exacerbation of chronic obstructive pulmonary disease and its clinical significance

目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者血清miRNA-146a水平及临床意义。方法选取2019年1月—2019年12月在杭州市西溪医院就诊的150例AECOPD患者作为AECOPD组,同期该院健康体检者150例作为对照组。逆转录聚合酶连反应(RT-PCR)测定血清miRNA-146a水平。测定血清C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)和第一秒用力呼气容积(FEV1)、用力肺活量(FVC)。结果 AECOPD组血清miRNA-146a、CRP、PCT及IL-6水平高于对照组(P<0.05)。AECOPD组FEV1、FVC及FEV1/FVC值低于对照组(P<0.05)。不同肺功能分级患者血清miRNA-146a水平比较,差异有统计学意义(P<0.05),随着肺功能分级升高,血清miRNA-146a水平升高(P<0.05)。死亡患者血清miRNA-146a水平高于存活患者(P<0.05)。AECOPD组血清miRNA-146a水平与血清CRP、PCT、IL-6水平呈正相关(r=0.526、0.571和0.543,P<0.05);而与FEV1、FVC及FEV1/FVC呈负相关(r=-0.532、-0.584和-0.561,P<0.05)。结论 AECOPD患者血清miRNA-146a水平升高,血清miRNA-146a水平与患者炎症反应程度、肺功能、病情和预后的关系密切。

Objective To investigate the level and clinical significance of serum miRNA-146a in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 150 patients with AECOPD from January 2019 to December 2019 in Xixi Hospital of Hangzhou were selected as the AECOPD group,and 150 healthy physical examinees during the same period were selected as the control group.Reverse transcription polymerase chain reaction(RT-PCR)was used to determine the level of serum miRNA-146a.The serum C-reactive protein(CRP),procalcitonin(PCT)and interleukin-6(IL-6)levels,as well as forced expiratory volume in one second(FEV1)and forced vital capacity(FVC)were measured.Results The levels of serum miRNA-146a,CRP,PCT and IL-6 in the AECOPD group were higher than those in the control group(P<0.05).The FEV1,FVC,and FEV1/FVC values of the AECOPD group were lower than those of the control group(P<0.05).There were statistically significant differences in serum miRNA-146a levels between each two groups with different lung function grades(P<0.05),and the serum level of miRNA-146a elevated with the increase of lung function grade.The serum miRNA-146a levels in death cases were higher than those in surviving patients(P<0.05).The serum miRNA-146a levels in the AECOPD group were positively correlated with serum CRP(r=0.526),PCT(r=0.571),IL-6(r=0.543)levels(P<0.05),and negatively correlated with FEV1(r=-0.532),FVC(r=-0.584),and FEV1/FVC(r=-0.561)(P<0.05).Conclusions Serum miRNA-146a level in AECOPD patient is elevated,and the serum miRNA-146a level is closely related to the degree of inflammatory response,lung function,as well as condition and prognosis of the disease.