miR-708与慢性乙型肝炎相关慢加急性肝衰竭患者预后的关系

Relationship between miR-708 and prognosis in patients with chronic hepatitis B associated acute-on-chronic liver failure

目的探究miR-708与慢性乙型肝炎(CHB)相关慢加急性肝衰竭(ACLF)患者预后的关系。方法前瞻性选取2018年3月至2020年6月在海南医学院第二附属医院就诊的128例CHB-ACLF患者(设为CHB-ACLF组)和100例CHB患者(设为CHB组)作为研究对象。根据CHB-ACLF患者的预后生存情况将其分为生存组(n=66)和死亡组(n=62)。采用实时荧光定量PCR法检测各组血清miR-708的表达水平,并分析其与CHB-ACLF患者预后90 d生存情况的关系。结果CHB-ACLF组的血清miR-708相对表达量低于CHB组(0.43±0.16比0.75±0.14),两组差异有统计学意义(P<0.05)。生存组的血清miR-708相对表达量高于死亡组(0.52±0.14比0.33±0.11),两组差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,国际标准化比值(INR)、肌酐和终末期肝病模型(MELD)评分是CHB-ACLF患者预后生存的独立危险因素(P<0.05),miR-708是CHB-ACLF患者预后生存的独立保护因素(P<0.05)。miR-708判断CHB-ACLF患者预后生存情况的ROC曲线下面积(AUC)为0.864,敏感度为79.03%,特异度为80.30%。限制性立方样条拟合logistic回归分析结果显示,miR-708与CHB-ACLF患者预后生存情况呈线性关系(非线性检验P>0.05)。结论检测CHB-ACLF患者血清miR-708的表达水平有助于判断患者的预后生存情况。

Objective This paper intends to study the relationship between miR-708 and prognosis in patients with chronic hepatitis B(CHB)associated acute-on-chronic liver failure(ACLF).Methods A total of 128 patients with CHB-ACLF(CHB-ACLF group)and 100 patients with CHB(CHB group)admitted to the Second Affiliated Hospital of Hainan Medical University from March 2018 to June 2020 were prospectively selected and assigned to the survival group(n=66)and the death group(n=62)based on the prognosis and survival of CHB-ACLF patients.The expression level of serum miR-708 was detected by real-time fluorescence quantitative PCR,and the relationship between miR-708 and the survival prognosis of patients with CHB-ACLF at 90 d was analyzed.Results The relative expression level of serum miR-708 in the CHB-ACLF group is lower than that in the CHB group(0.43±0.16 versus 0.75±0.14),with a statistically significant difference(P<0.05).The relative expression level of serum miR-708 in the survival group is higher than that in the death group(0.52±0.14 versus 0.33±0.11),with a statistically significant difference(P<0.05).Logistic regression analysis shows that the international normalized ratio(INR),creatinine,and the model for end-stage liver disease(MELD)score are independent risk factors for the prognosis of CHB-ACLF patients(P<0.05),and miR-708 is an independent protective factor for the prognosis of CHB-ACLF patients(P<0.05).The area under the ROC curve(AUC)of miR-708 predicting the prognostic survival of CHB-ACLF patients is 0.864,the sensitivity is 79.03%,and the specificity is 80.30%.Restrictive cubic spline fitting logistic regression analysis shows a linear relationship between miR-708 and the prognosis and survival of patients with CHB-ACLF(nonlinear test P>0.05).Conclusion Detection of the expression level of serum miR-708 in patients with CHB-ACLF is helpful to understand the prognosis.