急性胰腺炎患者血清葡萄糖调节蛋白78、miR-181-5p的表达及意义

Expression and clinical significance of glucose regulatory protein 78 and miR-181-5p in peripheral blood of patients with acute pancreatitis

目的探讨急性胰腺炎(AP)患者血清葡萄糖调节蛋白78(GRP78)、miR-181-5p的表达水平及其临床意义。方法选取141例AP患者作为研究对象,依据AP严重程度分为轻症组86例和重症组55例。另选取同期体检的健康人员100例纳入对照组。采用实时荧光定量PCR法检测受试者血清miR-181-5p、GRP78 mRNA表达水平。采用Pearson相关分析法分析血清miR-181-5p、GRP78 mRNA表达水平的相关性。采用受试者工作特征(ROC)曲线分析血清miR-181-5p、GRP78 mRNA表达水平对重症AP的预测价值。结果对照组、轻症组、重症组的血清miR-181-5p表达水平依次升高,GRP78 mRNA表达水平依次降低,差异有统计学意义(P<0.05)。miR-181-5p与GRP78 mRNA表达水平呈负相关(r=-0.665,P<0.05)。miR-181-5p表达水平偏高、GRP78 mRNA表达水平偏低是重症AP的危险因素(P<0.05)。ROC曲线显示,血清miR-181-5p预测重症AP的曲线下面积(AUC)为0.836,血清GRP78 mRNA预测重症AP的AUC为0.741,二者联合预测重症AP的AUC为0.861。结论AP患者血清miR-181-5p表达水平升高,GRP78 mRNA表达水平降低。miR-181-5p、GRP78与AP严重程度有关,对重症AP具有一定预测价值,可作为重症AP的潜在预测标志物。

Objective To investigate the expression and clinical significance of peripheral blood glucose regulatory protein 78(GRP78) and miR-181-5 p in patients with acute pancreatitis(AP). Methods A total of 141 AP patients were selected as research objects. According to the severity of AP, they were divided into mild group(86 cases) and severe group(55 cases). A total of 100 healthy people who underwent physical examinations in our hospital during the same period were selected as control group. Real-time fluorescent quantitative PCR method was used to detect the expression levels of serum miR-181-5 p and GRP78 mRNA in subjects. Pearson method was used to analyze the correlation between serum miR-181-5 p and GRP78 mRNA expression level. Receiver operating characteristic(ROC) curve was used to analyze the predictive value of serum miR-181-5 p and GRP78 mRNA expression levels for severe AP. Results The expression levels of serum miR-181-5 p in the control group, the mild group, and the severe group increased sequentially, and their expression levels of GRP78 mRNA decreased(P<0.05). The expression level of miR-181-5 p was negatively correlated with GRP78 mRNA(r=-0.665, P<0.05). Higher level of miR-181-5 p and lower level of GRP78 mRNA were risk factors affecting severe AP(P<0.05). ROC curve showed that the area under the curve(AUC) was 0.836 predicting severe AP by serum miR-181-5 p, was 0.741 by serum GRP78 mRNA, and was 0.861 by combined detection. Conclusion The miR-181-5 p expression level in serum increases and the GRP78 mRNA expression level decreases in AP patients, they are both related to the severity of AP. They have a certain predictive value for severe AP and may be used as potential predictive markers.