血清miR-21-3p、IL-18水平对重症急性胰腺炎患者急性肾损伤的预测价值

Predictive value of serum miR-21-3p and IL-18 levels on acute renal injury in patients with SAP

目的探讨血清微小核糖核酸-21-3p(miR-21-3p)、IL-18水平对重症急性胰腺炎(SAP)患者急性肾损伤(AKI)的预测价值。方法选择SAP患者195例,根据住院期间是否发生AKI分为AKI组57例、非AKI组138例。入院次日,采集清晨空腹肘静脉血,离心留取血清,采用实时荧光定量PCR技术检测血清miR-21-3p,采用ELISA法检测血清IL-18。收集所有研究对象基本病历资料(包括性别、年龄、BMI、糖尿病史、高血压史、收缩压、舒张压)、实验室检查资料[空腹血糖、TG、TC、HDL-C、LDL-C、血肌酐(Scr)、尿素氮(BUN)、高敏C反应蛋白(hs-CRP)、胱抑素C(Cys C)]、Ranson评分,采用Logistic回归模型分析SAP患者AKI发生的危险因素。采用受试者工作特征(ROC)曲线评估血清miR-21-3p、IL-18水平对SAP患者AKI发生的预测价值。结果AKI组血清miR-21-3p、IL-18水平均高于非AKI组(P均<0.05)。多因素Logistic回归分析发现,miR-21-3p、IL-18、Scr、BUN、hs-CRP、Cys C、Ranson评分均为SAP患者AKI发生的独立危险因素(P均<0.05)。ROC曲线分析显示,血清miR-21-3p、IL-18水平单独和联合预测SAP患者AKI发生的曲线下面积(AUC)分别为0.786、0.769、0.858,血清miR-21-3p、IL-18水平联合预测SAP患者AKI发生的AUC高于二者单独(P均<0.05)。结论血清miR-21-3p、IL-18是SAP患者AKI发生的独立危险因素;血清miR-21-3p、IL-18水平对SAP患者AKI发生均具有一定预测价值,二者联合时预测价值更高。

Objective To investigate the predictive value of serum microRNA-21-3p(miR-21-3p)and interleukin-18(IL-18)on acute renal injury(AKI)in patients with severe acute pancreatitis(SAP).Methods Totally 195 SAP patients were selected and divided into the AKI group(57 cases)and non-AKI group(138 cases)according to whether AKI occurred during hospitalization.The next day after admission,fasting elbow venous blood was collected in the morning,and the serum was centrifuged.The serum miR-21-3p was detected by real-time fluorescence quantitative PCR,and the serum IL-18 was detected by ELISA.The basic medical records(including gender,age,BMI,diabetes history,hypertension,systolic blood pressure,and diastolic blood pressure)and laboratory data(including FPG,TG,TC,HDL-C,LDL-C,Scr,BUN,hs-CRP,and Cys C)and Ranson score of all the subjects were collected.Logistic regression model was used to analyze the risk factors of AKI in SAP patients during hospitalization.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum miR-21-3p and IL-18 on AKI in SAP patients.Results The levels of serum miR-21-3p and IL-18 in the AKI group were higher than those in the non-AKI group(both P<0.05).Multivariate Logistic regression analysis showed that miR-21-3p,IL-18,Scr,BUN,hs-CRP,Cys C,and Ranson scores were independent risk factors for AKI in SAP patients during hospitalization(all P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum miR-21-3p and IL-18 alone and jointly in predicting the occurrence of AKI in SAP patients were 0.786,0.769 and 0.858,respectively.The AUC of serum miR-21-3p and IL-18 combined in predicting the occurrence of AKI in SAP patients during hospitalization was higher than that of them alone(all P<0.05).Conclusion Serum miR-21-3p and IL-18 are independent risk factors for AKI in SAP patients;the levels of serum miR-21-3p and IL-18 have a certain predictive value for AKI in SAP patients,and the predictive value of them combined is higher.