急性胰腺炎患者血浆miR-25-3p的表达水平与预后的关系

Relationship between plasma miR-25-3p level and prognosis in patients with acute pancreatitis

目的探究急性胰腺炎(AP)患者血浆miR-25-3p的表达水平与预后的关系。方法选择2016年4月至2020年7月中国人民解放军总医院第八医学中心(原中国人民解放军第三〇九医院)收治的325例AP患者作为研究对象。根据患者入院后28 d的生存情况将其分为生存组(n=269)和死亡组(n=56)。采用实时荧光定量PCR法检测AP患者血浆miR-25-3p的表达水平,并分析其与患者预后的关系。结果生存组和死亡组血浆miR-25-3p的表达水平随治疗时间延长均呈升高趋势。与死亡组比较,生存组治疗前(T0期)、治疗1 d(T1期)和治疗5 d(T2期)的血浆miR-25-3p表达水平均较高,两组差异均有统计学意义(P均<0.05)。多因素logistic回归分析结果显示,急性生理与慢性健康评分Ⅱ(APACHEⅡ)、急性胰腺炎严重程度床边指数(BISAP)、C反应蛋白(CRP)和乳酸是AP患者预后的独立危险因素(P<0.05),T0期miR-25-3p是AP患者预后的独立保护因素(P<0.05)。模型B(由APACHEⅡ评分、BISAP评分、CRP、乳酸和T0期miR-25-3p组成)评估AP患者预后的ROC曲线下面积大于模型A(由APACHEⅡ评分、BISAP评分、CRP和乳酸组成),差异有统计学意义(P<0.05)。当阈值概率>5%时,模型B预测AP患者预后的净收益高于模型A。结论AP患者血浆miR-25-3p的表达水平与预后关系密切。基于miR-25-3p构建的模型对于评估AP患者的预后情况具有一定价值。

Objective This paper attempts to explore the relationship between the plasma miR-25-3p level and prognosis in patients with acute pancreatitis(AP).Methods Three hundred and twenty-five AP patients admitted to the Eighth Medical Center of the Chinese People′s Liberation Army General Hospital(formerly the 309th Hospital of the Chinese People′s Liberation Army)from April 2016 to July 2020 were selected and assigned to the survival group(n=269)and the death group(n=56)according to their survival at 28 days after admission.Real-time fluorescence quantitative PCR was used to detect the plasma miR-25-3p level and analyze its relationship with the prognosis of AP patients.Results The miR-25-3p expression level in the survival group and the death group is found to increase with the extension of treatment.Compared with the death group,the survival group has a higher plasma miR-25-3p expression level before treatment(T0),1 day of treatment(T1)and 5 days of treatment(T2),with a statistically significant difference(P<0.05).The logistic regression analysis indicates that acute physiology and chronic health scoreⅡ(APACHEⅡ),bedside index of acute pancreatitis severity(BISAP),C-reactive protein(CRP)and lactate are independent risk factors for the prognosis of AP patients(P<0.05),while T0-miR-25-3p is an independent protective factor for the prognosis of AP patients(P<0.05).The area under the ROC curve of model B(consisting of APACHEⅡscore,BISAP score,CRP,lactate,and T0-miR-25-3p)for assessing the prognosis of AP patients is larger than that of model A(consisting of APACHEⅡscore,BISAP score,CRP,and lactate),with a statistically significant difference(P<0.05).When the threshold probability is greater than 5%,the net benefit of model B in predicting the prognosis of AP patients is higher than that of model A.Conclusions The miR-25-3p level in AP patients is closely related to the prognosis.The model based on miR-25-3p has certain values in evaluating the prognosis of AP patients.