稳定期COPD患者血清miR-181a与炎性因子的关系及对急性加重和死亡的预测价值

Relationship between serum miR-181a and inflammatory cytokines in stable COPD patients and its predictive value for acute exacerbation and death

目的:研究稳定期慢性阻塞性肺疾病(COPD)患者血清miR-181a与炎性因子的关系及对急性加重和死亡的预测价值。方法:选择2016-09—2018-06期间在我院就诊的120例稳定期COPD患者作为研究的稳定期COPD组,同期体检且一般资料匹配的80例健康志愿者作为研究的对照组。检测血清miR-181a的表达量及炎性因子(TNF-α、IL-6、IL-8)的含量,随访患者急性加重及死亡情况。采用ROC曲线分析miR-181a对急性加重及死亡的预测价值,采用Kaplan-Meier曲线分析miR-181a低表达及高表达患者急性加重及死亡的差异。结果:稳定期COPD组患者血清miR-181a的表达量明显低于对照组,血清TNF-α、IL-6、IL-8的含量明显高于对照组(P<0.05);稳定期COPD患者血清miR-181a表达量与TNF-α、IL-6、IL-8含量均呈负相关,相关系数分别为-0.726、-0.413、-0.323(P<0.05);与miR-181高表达稳定期COPD患者比较,miR-181低表达稳定期COPD患者第一次急性加重的中位时间、生存的中位时间均明显缩短(P<0.05);miR-181a预测稳定期COPD患者急性加重的最佳截点为0.575,预测稳定期COPD患者死亡的最佳截点为0.480。结论:稳定期COPD患者血清miR-181a减少与炎性因子释放增多有关且对急性加重和死亡均具有一定的预测价值。

Objective:To study the relationship between serum miR-181 a and inflammatory cytokines in stable chronic obstructive pulmonary disease(COPD)patients and its predictive value for acute exacerbation and death.Method:One hundred and twenty stable COPD patients admitted in our hospital from September 2016 to June 2018 were selected as the stable COPD group,and 80 healthy volunteers with matched general data were selected as the control group.The expression of miR-181 a and the contents of inflammatory cytokines(TNF-α,IL-6,IL-8)were measured.ROC curve was used to analyze the predictive value of miR-181 a for acute exacerbation and death,and Kaplan-Meier curve was used to analyze the difference of acute exacerbation and death between patients with low and high expression of miR-181 a.Result:The expression of miR-181 a in the stable COPD group was significantly lower than that in the control group,and the contents of TNF-α,IL-6 and IL-8 in the stable COPD group were significantly higher than that in the control group(P<0.05);the expression of miR-181 a in the stable COPD group was negatively correlated with the contents of TNF-α,IL-6 and IL-8,and the correlation coefficients were-0.726,-0.413 and-0.323,respectively(P<0.05);compared with patients with high expression of miR-181 in the stable COPD group,the median time of the first acute exacerbation and the median time of survival of patients with low expression of miR-181 were significantly shorter(P<0.05);the best cut-off point of miR-181 a for predicting the acute exacerbation of stable COPD patients was 0.575,and the best cut-off point for predicting the death was 0.480.Conclusion:The decrease of serum miR-181 a in stable COPD patients is related to the increase of the release of inflammatory factors,and has a certain predictive value for acute exacerbation and death.