血清miR-29a在胆石症患者中的表达水平及意义

Expression and significance of serum miR-29a in patients with cholelithiasis

目的探讨血清miR-29a在胆石症患者中的表达水平及意义。方法前瞻性选取2016年8月至2019年8月在金华市中心医院消化内科接受治疗的143例胆石症患者作为研究对象,设为胆石症组,另选取同期140例健康体检者作为对照组。采用实时荧光定量PCR(RT-qPCR)法检测受试者血清miR-29a的相对表达量,并分析其与疾病严重程度的关系。结果胆石症组血清miR-29a相对表达量高于对照组,差异有统计学意义(P<0.05)。与复杂性胆石症组相比较,单纯性胆石症组患者中肝硬化、腹腔积液比例及血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平较低,而高密度脂蛋白胆固醇(HDL-C)水平较高,差异均有统计学意义(P均<0.05)。血清miR-29a预测复杂性胆石症的受试者工作特征(ROC)曲线下面积(AUC)、敏感度、特异度、最佳截断点分别为0.842、71.79%、84.62%、1.15。多因素Logistic回归分析显示,肝硬化、腹腔积液、TC、miR-29a与复杂性胆石症的发生密切相关。结论胆石症患者血清miR-29a表达水平升高,并参与了胆石症的进展。检测miR-29a表达水平有助于评估胆石症的严重程度。

Objective An attempt is made in this paper to investigate the expression and significance of serum microRNA-29a(miR-29a)in patients with cholelithiasis.Methods A total of 143 patients with cholelithiasis who were treated in the Department of Gastroenterology of Jinhua Municipal Central Hospital from August 2016 to August 2019 were prospectively selected as study subjects,and assigned to the cholelithiasis group while 140 healthy people were assigned to the control group.Real-time fluorescence quantitative PCR(RT-qPCR)was used to detect the relative expression of serum miR-29a in patients,and its relationship with severity was analyzed.Results The relative expression of serum miR-29a in the cholelithiasis group was higher than that in the control group,with a statistically significant difference(P<0.05).The proportion of liver cirrhosis,peritoneal effusion and the level of total cholesterol(TC),triglycerides(TG),low density lipoprotein cholesterol(LDL-C)in the cholelithiasis group was lower than that in the complex cholelithiasis group,and high density lipoprotein cholesterol(HDL-C)levels were higher than those in the complex cholelithiasis group(P<0.05).The area under the receiver operating characteristic(ROC)curve(AUC),the sensitivity,the specificity,and the optimal cut-off point of serum miR-29a for predicting complex cholelithiasis were 0.842,71.79%,84.62%,and 1.15,respectively.Logistic multivariate regression analysis showed that cirrhosis,peritoneal effusion,TC,miR-29a were closely related to the occurrence of complicated cholelithiasis.Conclusions The expression of serum miR-29a is elevated in patients with cholelithiasis and participates in the progression of cholelithiasis.Detection of the expression of miR-29a is helpful in assessing the severity of cholelithiasis.