老年脓毒症患者血清miR-206及miR-451水平与疾病严重程度和预后的相关性研究

Correlation of Serum miR-206 and miR-451 Levels with Disease Severity and Prognosis in Elderly Patients with Sepsis

目的探讨血清微小核糖核酸(micro RNA,miR)-206及miR-451水平在老年脓毒症中的表达及其与严重程度和预后的关系。方法选取2018年1月~2020年12月儋州市人民医院收治的老年脓毒症患者158例,其中脓毒症非休克组94例和脓毒症休克组64例,另根据患者28天的生存情况,将其分为存活组(n=115)和死亡组(n=43)。比较各组第1,3和7天血清miR-206及miR-451表达水平变化。应用受试者工作特征(ROC)曲线分析血清miR-206及miR-451表达水平预测老年脓毒症患者死亡的价值。结果脓毒症休克组第1,3和7天血清miR-206(4.28±1.60,5.63±2.19,6.05±2.58)及miR-451(3.08±1.42,4.27±1.53,4.93±1.80)表达水平均明显高于脓毒症非休克组(2.62±1.05,3.15±1.40,2.96±1.27;1.93±0.86,2.46±1.02,2.30±0.95),差异有统计学意义(t=10.417~19.630,均P<0.01)。死亡组第1,3和7天血清miR-206(4.45±1.66,6.12±2.64,6.37±2.71)及miR-451(3.35±1.48,4.70±1.72,5.37±1.80)表达水平均明显高于存活组(2.50±0.97,2.90±1.35,2.83±1.31;1.80±0.81,2.17±0.92,2.05±0.86),差异有统计学意义(t=12.506~22.814,均P<0.01)。ROC曲线显示,第3天miR-206及miR-451两项联合预测老年脓毒症患者死亡的曲线下面积(0.936,95%CI:0.877~0.994)最大,其敏感度和特异度分别为97.2%和86.0%。结论血清miR-206及miR-451表达水平升高与老年脓毒症患者的严重程度及预后有关,第3天两项联合预测老年脓毒症患者死亡具有较好的价值。

Objective To investigate the expression of serum miR-206 and miR-451 in elderly sepsis and their relationship with severity and prognosis.Methods 158 patients with elderly sepsis admitted to Danzhou People’s Hospital from January 2018 to December 2020 were selected,including 94 patients in the sepsis non-shock group and 64 patients in the sepsis shock group.According to the 28 days survival condition,the patients were divided into survival group(n=115)and death group(n=43).The expression levels of serum miR-206 and miR-451 in each group were compared on the first,third and seventh day.The ROC curve were used to analyze the expression level of serum miR-206 and miR-451 to predict the death of patients with elderly sepsis.Results The expression level of serum miR-206(4.28±1.60,5.63±2.19,6.05±2.58)and miR-451(3.08±1.42,4.27±1.53,4.93±1.80)in septic shock group were significantly higher than that in sepsis non-shock group(2.62±1.05,3.15±1.40,2.96±1.27;1.93±0.86,2.46±1.02,2.30±0.95),the differences were statistically significant(t=10.417~19.630,all P<0.01).The expression levels of serum miR-206(4.45±1.66,6.12±2.64,6.37±2.71)and miR-451(3.35±1.48,4.70±1.72,5.37±1.80)in the first day,the third day and the seventh day of the death group were significantly higher than those in the survival group(2.50±0.97,2.90±1.35,2.83±1.31;1.80±0.81,2.17±0.92,2.05±0.86),the differences were statistically significant(t=12.506~22.814,all P<0.01).ROC curve showed that the area under the curve(0.936,95%CI:0.877~0.994)of the combined of miR-206 and miR-451 predicting the death of elderly sepsis patients was the largest,and its sensitivity and specificity were 97.2%and 86.0%.Conclusion The increased expression levels of serum miR-206 and miR-451 were associated with the severity and prognosis of elderly sepsis patients,and the combination of the two items on the third day can predict the death of elderly sepsis patients.