血清miR-155-5p对感染性休克的诊断及预后评估价值

Value of serum miR-155-5p in diagnosis of septic shock and assessment of prognosis

目的探究血清微小RNA(miR)-155-5p水平对感染性休克的诊断及预后评估价值。方法选取2015年6月-2020年6月滨州医学院附属医院重症医学科(ICU)收治的855例感染性休克患者为研究组,同期100例未合并感染性休克患者为对照组,根据治疗效果,将研究组分为未缓解患者377例,缓解患者478例。对所有患者的基线资料、确诊时血清miR-155-5p、白细胞介素-6(IL-6)、降钙素原(PCT)、C-反应蛋白(CRP)水平及疗效进行分析。结果研究组患者血清miR-155-5p相对表达量及IL-6、PCT、CRP水平高于对照组,差异均有统计学意义(P<0.05),未缓解患者血清miR-155-5p相对表达量及IL-6、PCT、CRP水平均高于缓解患者,差异均有统计学意义(P<0.05)。受试者工作特征曲线(ROC)结果显示,血清miR-155-5p相对表达量及IL-6、PCT、CRP水平诊断感染性休克的曲线下面积(AUC)均有统计学意义(P<0.05);在预测感染性休克治疗后未缓解方面,血清miR-155-5p相对表达量及IL-6、PCT、CRP水平的AUC均有统计学意义(P<0.05),血清miR-155-5p相对表达量的AUC较高,在Cutoff值下,灵敏度和特异度分别为85.10%和80.10%。结论血清miR-155-5p、IL-6、PCT、CRP水平在诊断感染性休克方面的价值基本相当,而miR-155-5p在预测治疗效果方面的价值高于其他指标,有望作为预测病情转归的新型标志物。

OBJECTIVE To explore the value of serum microRNA(miR)-155-5 p in diagnosis of septic shock and assessment of prognosis. METHODS A total of 855 patients with septic shock who were treated in intensive care unit(ICU) of the Affiliated Hospital of Binzhou Medical College of Shandong Province from Jun 2015 to Jun 2020 were assigned as the study group, meanwhile, 100 patients who were not complicated with septic shock were set as the control group. The patients of study group were divided into the patients without remission(377 cases) and the patients with remission(478 cases) according to the curative effect. The baseline data, levels of serum miR-155-5 p, interleukin-6(IL-6), procalcitonin(PCT) and C-reactive protein(CRP)at the diagnosis as well as the curative effects were observed. RESULTS The relative expression level of serum miR-155-5 p and levels of IL-6, PCT and CRP of the study group were significantly higher than those of the control group(P<0.05);the relative expression level of serum miR-155-5 p and levels of IL-6, PCT and CRP of the patients without remission were significantly higher than those of the patients with remission(P<0.05). The result of receiver operating characteristic(ROC) curve analysis showed that there was significant difference in the area under curve(AUC) in diagnosis of septic shock between the relative expression level of serum miR-155-5 p and the levels of IL-6, PCT and CRP(P<0.05);there was significant difference in the AUC in prediction of the remission after treatment of septic shock between the relative expression level of serum miR-155-5 p and the levels of IL-6, PCT and CRP(P<0.05). The AUC of the relative expression level of serum miR-155-5 p was the relatively high, under the cut-off value, the sensitivity and specificity were 85.10% and 80.10%, respectively. CONCLUSION The values of the serum miR-155-5 p, IL-6, PCT and CRP are basically the same in the diagnosis of septic shock, but the miR-155-5 p has higher value in prediction of the curative effect, which is expected to be used as a new marker for prediction of treatment outcomes.