尿沉渣miR-330-3p在脓毒症相关急性肾损伤诊断中的价值

Value of miR-330-3p in urine sediment to the diagnosis of sepsis-associated acute kidney injury

目的检测脓毒症相关急性肾损伤(acute kidney injury, AKI)患者尿沉渣miR-330-3p表达,探讨其在脓毒症相关AKI诊断中的价值。方法 4例体检健康者、4例未发生AKI的脓毒症患者、4例脓毒症相关AKI患者为筛选队列,采用高通量测序技术筛选尿沉渣中差异性表达的miRNA,选择差异表达倍数较高的miR-330-3p进行验证。20例脓毒症患者(脓毒症组)和26例脓毒症相关AKI患者(脓毒症AKI组)为验证队列,采用实时荧光定量PCR法检测2组尿沉渣miR-330-3p相对表达量;绘制ROC曲线,评估尿沉渣miR-330-3p诊断脓毒症患者发生AKI的效能。结果高通量测序技术筛选出43个差异性表达的miRNA。实时荧光定量PCR检测结果显示,脓毒症AKI组尿沉渣miR-330-3p相对表达量[4.641(0.733,12.90)]高于脓毒症组[0.689(0.482,0.997)](P<0.05)。尿沉渣miR-330-3p相对表达量以0.604为最佳截断值,诊断脓毒症患者发生AKI的AUC为0.737(95%CI:0.573~0.899,P<0.05),灵敏度为65.4%,特异度为99.5%。结论尿沉渣miR-330-3p有可能成为脓毒症相关AKI特异度较高的无创诊断标志物之一。

Objective To detect the expression of miR-330-3 p in urine sediment in patients with sepsis-associated acute kidney injury(AKI), and to investigate its value to the diagnosis of sepsis-associated AKI. Methods The microRNAs with different expressions in urine sediment were screened by high-throughput sequencing technology in screening cohort including 4 healthy volunteers, 4 septic patients without AKI and 4 patients with sepsis-associated AKI. MiR-330-3 p with high differential expression multiple was chosen and verified. In the validation cohort of 20 septic patients(sepsis group) and 26 sepsis-associated AKI patients(septic AKI group), the relative expressions of miR-330-3 p were detected in two groups by real-time fluorescence quantitative PCR. ROC was drawn to assess the value of miR-330-3 p to the diagnosis of sepsis-associated AKI. Results Forty-three differentially expressed microRNAs were screened by high-throughput sequencing technology. Real-time fluorescence quantitative PCR showed that the relative expression of miR-330-3 p was higher in septic AKI group(4.641(0.733, 12.90)) than that in sepsis group(0.689(0.482, 0.997))(P<0.05). When the optimal cut-off value of miR-330-3 p was 0.604, the AUC for diagnosing sepsis-associated AKI was 0.737(95%CI: 0.573-0.899, P<0.05), with a sensitivity of 65.4% and sensitivity of 99.5%. Conclusion MiR-330-3 p in urine sediment is expected to be a non-invasive diagnostic marker specific to sepsis-associated AKI.