血清miR-10a、IL-33水平对重症急性胰腺炎患者并发急性肾损伤的预测价值

Predictive value of serum miR-10a and IL-33 levels in patients with severe acute pancreatitis complicated with acute kidney injury

目的分析血清微小RNA-10a(miR-10a)、白细胞介素-33(IL-33)水平对重症急性胰腺炎(SAP)患者并发急性肾损伤(AKI)的预测价值。方法选取2016年1月—2019年12月于成都中医药大学附属成都市第五人民医院就诊的SAP患者163例作为研究对象,根据是否并发AKI分为AKI组(48例)和非AKI组(115例)。比较两组患者血清中miR-10a、IL-33及一般临床资料,探讨SAP患者并发AKI的影响因素,分析miR-10a、IL-33对SAP患者并发AKI的预测价值。结果AKI组血清中miR-10a、IL-33、Ranson评分、超敏C反应蛋白(hs-CRP)、降钙素原、中性粒细胞明胶酶相关脂质运载蛋白明显高于非AKI组,差异有统计学意义(P<0.05)。logistic多因素回归分析显示,miR-10a(OR=1.764)、IL-33(OR=1.863)、Ranson评分(OR=1.631)、hs-CRP(OR=1.547)均是SAP患者并发AKI的危险因素(P<0.05)。miR-10a、IL-33预测SAP患者并发AKI的ROC曲线下面积(AUC)分别为0.828、0.807,二者联合预测的AUC为0.893,高于miR-10a、IL-33,差异有统计学意义(P<0.05)。结论SAP并发AKI患者血清中miR-10a、IL-33水平明显升高,且二者对AKI具有较好的预测价值,二者联合检测可为AKI的早期识别提供帮助。

Objective To analyze the predictive value of serum microRNA-10a(miR-10a)and interleukin-33(IL-33)levels in patients with severe acute pancreatitis(SAP)complicated by acute kidney injury(AKI).Methods A total of 163 SAP patients from January 2016 to December 2019 in Chengdu Fifth People’s Hospital Affiliated to Chengdu University of Traditional Chinese Medicine were selected and divided into AKI group(48 cases)and non AKI group(115 cases)according to whether AKI was complicated.The serum miR-10a,IL-33 and general clinical data between the two groups were compared.The influencing factors of AKI in SAP patients were discussed,and the predictive value of miR-10a and IL-33 on AKI in SAP patients were analyzed.Results The serum levels of miR-10a,IL-33,Ranson score,high-sensitivity C-reactive protein(hs-CRP),procalcitonin,and neutrophil gelatinase-associated lipocalin in the AKI group were significantly higher than those in the non-AKI group,and the differences were statistically significant(P<0.05).Logistic multivariate regression analysis showed that miR-10a(OR=1.764),IL-33(OR=1.863),Ranson score(OR=1.631),hs-CRP(OR=1.547)were all risk factors for SAP patients with AKI(P<0.05).The area under the ROC curve(AUC)predicted by miR-10a and IL-33 for SAP patients with AKI were 0.828 and 0.807,respectively.The combined predicted AUC of the two was 0.893,which was higher than miR-10a and IL-33,and the differences were statistically significant.(P<0.05).Conclusion Serum levels of miR-10a and IL-33 are significantly increased in SAP patients with AKI,and they have good predictive value for AKI.Combined detection can provide help for the early identification of AKI.