急性肺损伤患者血浆miR-221及miR-300表达水平及与预后相关性分析

Expression levels of plasma miR-221 and miR-300 in patients with acute lung injury and their correlation with prognosis

目的探讨急性肺损伤(ALI)患者血浆miR-221及miR-300表达水平及其与预后相关性。方法选取2016年1月至2019年6月该院收治的ALI患者137例,根据ALI患者生存情况分为存活组(n=90)和死亡组(n=47)。采用急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分标准将ALI患者分为低中危组(n=74)和高危组(n=63)。采用实时荧光定量PCR检测各组血浆miR-221及miR-300表达水平。应用多因素Logistic回归分析ALI患者死亡的危险因素。绘制受试者工作特征曲线(ROC曲线)分析血浆miR-221及miR-300表达水平对ALI患者死亡的预测价值。结果死亡组血浆miR-221及miR-300表达水平均明显高于存活组,差异有统计学意义(P<0.05)。高危组血浆miR-221、miR-300表达水平及病死率均明显高于低中危组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,血浆miR-221(OR=3.270,95%CI:2.247~7.115)及miR-300(OR=2.683,95%CI:1.715~6.207)表达水平升高是ALI患者死亡的独立危险因素。ROC曲线分析显示,血浆miR-221及miR-300表达水平预测ALI患者死亡的最佳截断值分别为2.80、1.73,二者联合预测ALI患者死亡的曲线下面积(0.907,95%CI:0.858~0.974)最大。结论血浆miR-221及miR-300表达水平升高与ALI患者预后不良相关,且其是ALI患者死亡的独立危险因素,二者联合对预测ALI患者死亡具有一定的价值。

Objective To investigate the expression levels of plasma miR-221 and miR-300 in patients with acute lung injury(ALI)and their correlation with prognosis.Methods Totally 137 patients with ALI admitted to a hospital from January 2016 to June 2019 were selected and divided into survival group(n=90)and death group(n=47)according to the survival condition of ALI patients.ALI patients were divided into low middle risk group(n=74)and high risk group(n=63)according to the acute physiology and chronic health score systemⅡ(APACHEⅡ).Real-time fluorescent quantitative PCR was used to detect the expression levels of plasma miR-221 and miR-300 in each group.Multivariate Logistic regression was used to analyze the risk factors of death in ALI patients.Draw the receiver operating characteristic curve(ROC curve)analysis of plasma miR-221 and miR-300 expression levels predicts the value of death in patients with ALI.Results The expression levels of plasma miR-221and miR-300 in the death group were significantly higher than those in the survival group,the difference was statistically significant(P<0.05).The expression levels of plasma miR-221,miR-300 and mortality in the high risk group were significantly higher than those in the low middle risk group,the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis showed that the increased expression levels of plasma miR-221(OR=3.270,95%CI:2.247-7.115)and miR-300(OR=2.683,95%CI:1.715-6.207)were independent risk factors for ALI death.ROC curve analysis showed that the plasma miR-221,miR-300 expression levels predicts the optimal cutoff value of death in patients with ALI were 2.80,1.73,respectively.Two joint predict the area under the curve(0.907,95%CI:0.858-0.974)of death in patients with ALI were the largest.Conclusion Plasma miR-221 and miR-300 expression levels associated with poor prognosis of patients with ALI,are the independent risk factors of death in patients with ALI,and the two joint for predicting death ALI has a certain value.