颅脑损伤继发肺部感染患者外周血单个核细胞miRNA表达谱及其临床意义

MiRNA expression profile of peripheral blood monocytes in patients with pulmonary infection secondary to craniocerebral injury and its clinical significance

目的分析颅脑损伤继发肺部感染患者的外周血单个核细胞微小核糖核酸(miRNA)表达谱变化及其临床意义。方法选取2015年3月-2019年3月复旦大学附属华山医院收治的颅脑损伤继发肺部感染患者156例为研究组,另选同期颅脑损伤未发生肺部感染患者131例为对照组。比较两组患者外周血单个核细胞miRNA表达谱差异。结果芯片杂交结果显示,研究组与对照组患者有差异表达且改变倍数≥2倍的miRNA共42种,其中表达上调18个,下调24个;实时荧光定量-聚合酶链式反应(qRT-PCR)复筛结果显示,miR-146a、miR-125b、miR-155和miR-22-3p在研究组患者中的表达与对照组患者比较,差异有统计学意义(P<0.05);受试者工作特征(ROC)曲线分析结果显示,miR-146a、miR-125b、miR-155和miR-22-3p的曲线下面积(AUC)值分别为0.760、0.734、0.855和0.781,对颅脑损伤继发肺部感染的诊断效率较高(P<0.05)。结论临床检测miR-146a、miR-125b、miR-155和miR-22-3p表达谱有助于颅脑损伤患者继发肺部感染的诊断,可作为颅脑损伤继发肺部感染临床诊疗评估的重要指标。

OBJECTIVE To analyze the changes of micro-ribonucleic acid(miRNA)expression profile of peripheral blood monocytes in patients with pulmonary infection secondary to craniocerebral injury and its clinical significance.METHODS A total of 156 patients with pulmonary infection secondary to craniocerebral injury admitted to the Huashan Hospital Affiliated to Fudan University from Mar.2015 to Mar.2019 were selected as the study group,and 131 patients with craniocerebral injury without pulmonary infection during the same period were selected as the control group.The difference in miRNA expression profiles of peripheral blood monocytes between the two groups were compared.RESULTS The microarray hybridization results showed that 42 miRNAs were differentially expressed and changed by twice or more times in the study group and control group,of which 18 were up-regulated and 24 were down-regulated.Results of qRT-PCR re-screening showed that the expression of miR-146 a,miR-125 b,miR-155 and miR-22-3 p in the study group were significantly different from those in the control group(P<0.05).The results of receiver operator characteristic curve(ROC)analysis showed that the AUC values of miR-146 a,miR-125 b,miR-155 and miR-22-3 p were 0.760,0.734,0.855 and 0.781,respectively,which were more efficient in the diagnosis of pulmonary infection secondary to craniocerebral injury(P<0.05).CONCLUSION Clinical detection of miR-146 a,miR-125 b,miR-155 and miR-22-3 p expression profiles was helpful for the diagnosis of secondary pulmonary infection in patients with craniocerebral injury,and can be used as important indicators for clinical diagnosis and treatment of pulmonary infection secondary to craniocerebral injury.