急性胰腺炎患者外周血ATG5、miR-30-5p水平与患者病情严重程度及预后的关系

The relationships between the levels of ATG5 and miR-30-5p in peripheral blood and the severity,prognosis of patients with acute pancreatitis

目的探讨急性胰腺炎患者外周血自噬相关蛋白5(ATG5)、微小RNA-30-5p(miR-30-5p)水平与病情严重程度及预后的关系。方法选取200例急性胰腺炎患者为研究对象,按照病情严重程度将其分为轻症组和重症组;根据治疗4周后的预后情况将其分为死亡组和存活组。选取同期体检健康者90例为对照组。采用实时荧光定量聚合酶链反应检测外周血中ATG5、miR-30-5p水平;采用Pearson相关分析ATG5与miR-30-5p水平的相关性;采用Kaplan-Meier法分析ATG5、miR-30-5p水平与急性胰腺炎患者预后的关系。结果重症组、轻症组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、脂肪酶、C反应蛋白(CRP)、急性生理与慢性健康评估系统Ⅱ(APACHEⅡ)评分及ATG5水平明显高于对照组,高密度脂蛋白胆固醇(HDL-C)、miR-30-5p水平明显低于对照组,差异有统计学意义(P<0.05);重症组TC、TG、LDL-C、脂肪酶、CRP、APACHEⅡ评分、急性胰腺炎严重程度床边指数(BISAP)评分及ATG5水平明显高于轻症组,HDL-C、miR-30-5p水平明显低于轻症组,差异有统计学意义(P<0.05)。Pearson相关分析结果显示,急性胰腺炎患者外周血中ATG5与miR-30-5p水平呈负相关(r=—0.568,P<0.001)。与对照组比较,存活组和死亡组外周血中ATG5水平明显升高,miR-30-5p水平明显降低,差异有统计学意义(P<0.05);与存活组比较,死亡组外周血中ATG5水平明显升高,miR-30-5p水平明显降低,差异有统计学意义(P<0.05)。ATG5高表达患者生存率(78.57%)明显低于ATG5低表达患者生存率(93.14%),miR-30-5p高表达患者生存率(94.23%)明显高于miR-30-5p低表达患者生存率(77.08%),差异有统计学意义(P<0.05)。结论miR-30-5p在急性胰腺炎患者中低表达,ATG5在急性胰腺炎患者中高表达,二者均与急性胰腺炎患者病情严重程度及预后有关,是评估急性胰腺炎患者预后的潜在标志物。

Objective To explore the relationships between the levels of autophagy-related protein 5(ATG5),microRNA-30-5p(miR-30-5p)in peripheral blood and the severity,prognosis of patients with acute pancreatitis.Methods A total of 200 patients with acute pancreatitis selected as the research objects,and divided into mild group and severe group according to their severity.The patients were divided into death group and survival group according to their prognosis after 4 weeks of treatment.Over the same period,90 healthy check people were randomly selected as the control group.The levels of ATG5 and miR-30-5p in peripheral blood were detected by real-time quantitative polymerase chain reaction.Pearson correlation method was used to analyze the correlation between ATG5 and miR-30-5p.Kaplan-Meier method was used to analyze the relationships between the levels of ATG5 and miR-30-5p and the prognosis of patients with acute pancreatitis.Results The total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterin(LDL-C),lipase,C-reactive protein(CRP),acute physiology and chronic health assessment systemⅡ(APACHEⅡ)score and ATG5 in the severe group and the mild group were significantly higher than those in the control group,the high density lipoprotein cholesterol(HDL-C)and miR-30-5p were significantly lower than those in the control group,the differences were significant(P<0.05).The TC,TG,LDL-C,lipase,CRP,APACHEⅡscore,BISAP score and ATG5 in the severe group were significantly higher than those in the mild group,the HDL-C and miR-30-5p were significantly lower than those in control group,the differences were significant(P<0.05).Pearson correlation analysis showed that the levels of ATG5 and miR-30-5p in the peripheral blood of patients with acute pancreatitis correlated negatively(r=—0.568,P<0.001).Compared with the control group,the peripheral blood ATG5 level in the survival group and the death group increased significantly,and the miR-30-5p level reduced significantly,the differences were statistically significant(P<0.05).Compared with the survival group,the ATG5 level in the peripheral blood in the death group was significantly higher,and the miR-30-5p level was significantly lower,the differences were statistically significant(P<0.05).The survival rate of patients with high expression ATG5(78.57%)was significantly lower than that of patients with low expression ATG5(93.14%),and the survival rate of patients with high expression miR-30-5p(94.23%)was significantly higher than that of patients with low expression miR-30-5p(77.08%,P<0.05).Conclusion mir-30-5p expresses lowly in patients with acute pancreatitis,and ATG5 expresses highly in patients with acute pancreatitis.Both the two indicators relate to the severity and prognosis of patients with acute pancreatitis,and they are expected to be potential markers to evaluate the prognosis of patients with acute pancreatitis.