微小RNA-103及RNA-107表达与120例脓毒症患者临床特征及预后的关联分析

Correlations of microRNA-103 and microRNA-107 expressions with the clinical characteristics and prognosis of 120 cases of sepsis

目的评估血浆微小RNA-103(miR-103)和RNA-107(miR-107)对脓毒症患病死亡风险的预判,并探讨其与脓毒症患者疾病严重程度及预后有关联的因素。方法选取2016年1月至2019年6月接受治疗的脓毒症患者120例(脓毒症组),入院24 h之内收集血液样本;选取同期健康对照者120例(健康对照组),入组时收集血液样本,并分离血液样本中血浆。采用反转录-荧光定量聚合酶链式反应检测所有受试者血浆miR-103和miR-107的表达水平。采用酶联免疫吸附试剂盒检测脓毒症组血浆中某些炎症因子的表达水平。收集脓毒症组临床指标并计算其28 d死亡率。采用受试者工作曲线(ROC)对临床辅助诊断的预判分析,采用Cox?s回归模型分析脓毒血症死亡的关联因素。结果miR-103和miR-107在脓毒症组表达水平相比健康对照组均降低,且可作为脓毒症临床诊断的辅助指标,其曲线下面积(AUC)分别为0.893(95%CI:0.854~0.933)及0.941(95%CI:0.913~0.968)。脓毒症组miR-103和miR-107表达水平与急性生理和慢性健康状态II评分、序贯器官功能衰竭评分、血清肌酐、C-反应蛋白、肿瘤坏死因子-α、白介素-1β、白介素-6及白介素-8均呈负相关,与白蛋白呈正相关。此外,miR-103和miR-107在脓毒症死亡患者中表达水平较脓毒症存活患者降低。多元Cox?s回归分析结果显示,miR-103表达是预测脓毒症组28 d死亡率的独立因素。结论miR-103和miR-107低表达与脓毒症相关,并与脓毒症患者疾病严重程度及28 d死亡率相关。

Objective To evaluate the predictive values of plasma microRNA(miR)-103 and miR-107 for septic death,and their correlations with disease severity as well as prognosis.Methods A total of 120 sepsis patients who received treatment in our hospital during Jan.2016 and Jun.2019(sepsis group)were enrolled and their plasma samples were collected within 24 h after enrollment;meanwhile,120 contemporaneous healthy controls(HC group)were recruited and their plasma samples were collected.Plasma miR-103 and miR-107 expressions were detected with reverse transcription-quantitative polymerase chain reaction.Several plasma inflammatory cytokines were detected with enzyme-linked immune sorbent assay.In sepsis patients,clinical characteristics were collected and 28-day mortality rate was calculated.The supportive diagnostic value for sepsis was analyzed with receiver operating characteristic(ROC)curve.The associated factors of sepsis death were analyzed with multivariate Cox?s regression model.Results The sepsis group had reduced miR-103 and miR-107 expressions than HC group.The miR-103 and miR-107 expressions could serve as supportive indexes for sepsis diagnosis,and their area under curve(AUC)was 0.893(95%CI:0.854-0.933)and 0.941(95%CI:0.913-0.968),respectively.In sepsis group,miR-103 and miR-107 expressions were negatively correlated with acute pathologic and chronic health evaluation II score,sequential organ failure assessment score,serum creatinine,C-reactive protein,tumor necrosis factor-α,interleukin-1β,interleukin-6 and interleukin-8,while positively correlated with albumin.Moreover,miR-103 and miR-107 expressions decreased in septic deaths compared to septic survivors.Multivariate Cox?s regression analysis revealed that miR-103 expression was an independent factor for 28-day mortality risk of sepsis patients.Conclusion Reduced miR-103 and miR-107 expressions are correlated with sepsis incidence,as well as disease severity and 28-day mortality.