miRNA-15a及miRNA-182在脓毒血症中的表达与疾病严重程度和预后的关系

Epressions of miRNA-15a and miRNA-182 in sepsis and its correlation with disease severity and prognosis

目的探索血microRNA-15a(miR-15a)及microRNA-182(miR-182)表达情况与脓毒症的严重程度和预后的关系。方法选择55例脓毒症患者,通过实时荧光定量聚合酶链反应(RT-qPCR)检测miR-15a和miR-182的表达,并记录其他临床数据、炎症指标和28 d预后。分析比较脓毒症组与脓毒症性休克组、28 d内生存组与死亡组在血miR-15a与miR-182、临床数据、炎症指标间的差异,以及比较28 d内生存组与死亡组同血循环miR-15a与miR-182动态变化之间的关系。结果55例患者诊断为脓毒症28例、脓毒症性休克27例。在0 h时,脓毒症组降钙素原(PCT)水平和序贯器官衰竭评估(SOFA)评分明显低于脓毒症性休克组(t=-2.78,Z=642.00,P均<0.05);miR-182相对表达量明显低于脓毒症性休克组(t=-5.81,P<0.05)。55例患者28 d内生存45例,死亡10例。在0 h时,生存组患者的C-反应蛋白(CRP)、PCT水平和SOFA评分均低于死亡组(t分别=-2.97、-2.05,Z=79.00,P均<0.05);miR-182相对表达量明显低于死亡组(t=-3.92,P<0.05)。在72 h时,生存组患者的CRP、PCT水平和SOFA评分均低于死亡组(t分别=-4.28、-3.95,Z=5.50,P均<0.05);miR-182相对表达量明显低于死亡组,miR-15a相对表达量明显高于死亡组(t分别=-5.31、3.31,P均<0.05)。脓毒症生存组患者72 h的CRP、PCT、miR-182的下降程度明显大于死亡组(t分别=-3.12、-3.51、-10.19,P均<0.05),而miR-15a的回升程度明显大于死亡组(t=11.19,P<0.05)。结论miR-15a和miR-182可作为一种潜在的生物标志物,有助于脓毒症患者的疾病严重程度分层和预后判断。

Objective To explore the plasma miRNA-15a and miRNA-182 expressions with in sepsis and its correlation with disease severity and prognosis.Methods A total of 55 patients with sepsis were selected.The expressions of circulating miRNA-15a and miRNA-182 were detected by RT-qPCR,and other clinical data,inflammatory biomarkers and 28-day prognosis were recorded.The differences of circulation miRNA-15a and miRNA-18,clinical data and inflammatory biomarkers between sepsis group and septic shock group,survival group and death group were analyzed and compared,and the dynamic changes of circulating miRNA-15a and miRNA-182 between survival group and death group were compared.Results Among the 55 patients,28 were diagnosed as sepsis and 27 were diagnosed as septic shock.At 0h,the levels of procalcitonin(PCT)and sequential organ failure assessment(SOFA)score in septic group were lower than those in septic shock group(t=-2.78,Z=642.00,P<0.05),and the relative expression of miR-182 was lower than that in septic shock group(t=-5.81,P<0.05).Of the 55 patients,45 survived and 10 died within 28 days.At 0h,PCT and SOFA in the survival group were lower than those in the death group(t=-2.97,-2.05,Z=79.00,P<0.05),and the relative expression of miRNA-182 was lower than that in the death group(t=-3.92,P<0.05).At 72 h,the CRP,PCT and SOFA of the survival group were lower than those of the death group(t=-4.28,-3.95,Z=5.50,P<0.05),the relative expression of miR-182 was lower than that of the death group,but the relative expression of miRNA-15a was higher than that of the death group,the differences were statistically significant(t=-5.31,3.31,P<0.05).The CRP,PCT and miRNA-182 in the survival group of sepsis at 72h was lower than that in the death group(t=-3.12,-3.51,-10.19,P<0.05),the miRNA-15a in survival group was higher than that in death group(t=11.19,P<0.05).Conclusion MiRNA-15a and miRNA-182 can be used as potential biomarkers to help to stratify the disease severity and judge the prognosis of patients with sepsis.