miR-223在自发性细菌性腹膜炎患者中的表达及临床意义

Expression and clinical significance of miR-223 in patients with spontaneous bacterial peritonitis

目的探讨微小RNA-223(miR-223)在自发性细菌性腹膜炎(SBP)中的水平及其临床意义。方法选取2017年9月~2022年1月本院收治的100例乙肝肝硬化并发SBP患者为肝硬化并发SBP组,另选取同期100例单纯乙肝肝硬化腹水患者为肝硬化组。比较肝硬化组、肝硬化并发SBP组一般资料及腹水miR-223、降钙素原(PCT)、白介素-6(IL-6)水平;分析肝硬化并发SBP患者腹水miR-223表达水平与PCT、IL-6的相关性;分析腹水miR-223、PCT、IL-6对肝硬化并发SBP的诊断价值。结果肝硬化并发SBP组患者年龄、男/女比、嗜酒史占比、糖尿病占比、肝昏迷占比、住院时间与肝硬化组无明显差异(P>0.05);肝硬化并发SBP组患者腹水miR-223[(1.93±0.64)ng/mL]、PCT[(0.91±0.36)ng/mL]、IL-6[(53.58±21.43)ng/mL]水平均高于肝硬化组[(1.01±0.34)ng/mL、(0.42±0.17)ng/mL、(32.44±12.98)ng/mL](P<0.05);肝硬化并发SBP患者腹水miR-223表达水平与PCT、IL-6均呈正相关(r=0.573、0.594,P<0.05);腹水miR-223、PCT、IL-6诊断肝硬化并发SBP的曲线下面积(AUC)分别为0.896、0.895、0.692,其截断值分别为1.50、0.70 ng/mL、43.95 ng/mL,敏感度分别为89.0%、88.0%、57.0%,特异性分别为78.0%、79.0%、73.0%,且腹水miR-223与PCT联合诊断肝硬化并发SBP的AUC为0.953,其敏感度为88.0%,特异性为94.0%。结论肝硬化并发SBP患者腹水miR-223表达水平较高,与PCT、IL-6呈正相关,miR-223有望成为诊断肝硬化并发SBP的标志物,且其与PCT联合可更好地诊断肝硬化并发SBP,为临床诊断肝硬化并发SBP提供新方案。

Objective To investigate the level and clinical significance of microRNA-223(miR-223)in spontaneous bacterial peritonitis(SBP).Methods One-hundred patients with hepatitis B cirrhosis complicated with SBP who were accepted by our hospital from September 2017 to January 2022 were gathered as the liver cirrhosis complicated with SBP group.Another 100 patients with simple hepatitis B cirrhosis with ascites were regarded as the liver cirrhosis group.The general data and the levels of miR-223,procalcitonin(PCT)and interleukin-6(IL-6)in ascites were compared between the liver cirrhosis group and the liver cirrhosis complicated with SBP group;the correlation between the expression level of miR-223 in ascites of patients with liver cirrhosis complicated with SBP and PCT and IL-6 was analyzed;the diagnostic value of ascites miR-223,PCT and IL-6 in liver cirrhosis complicated with SBP was analyzed.Results There was no significant difference in age,male/female ratio,proportion of alcoholism history,proportion of diabetes,proportion of hepatic coma,and hospital stay between the liver cirrhosis complicated with SBP group and the liver cirrhosis group(P>0.05);the levels of miR-223[(1.93±0.64)ng/mL],PCT[(0.91±0.36)ng/mL]and IL-6[(53.58±21.43)ng/mL]in ascites in patients with liver cirrhosis complicated with SBP were higher than those in the liver cirrhosis group[(1.01±0.34)ng/mL,(0.42±0.17)ng/mL,(32.44±12.98)ng/mL](P<0.05);the expression level of miR-223 in ascites of patients with liver cirrhosis complicated with SBP was positively correlated with PCT and IL-6(r=0.573,0.594,P<0.05);the areas under the curve(AUCs)of ascites miR-223,PCT,and IL-6 in the diagnosis of liver cirrhosis complicated with SBP were 0.896,0.895,and 0.692,respectively,the cut-off values were 1.50,0.70 ng/mL,and 43.95 ng/mL,respectively,the sensitivities were 89.0%,88.0%,and 57.0%,respectively,the specificities were 78.0%,79.0%,73.0%,respectively,the AUC of ascites miR-223 combined with PCT in the diagnosis of liver cirrhosis complicated with SBP was 0.953,with a sensitivity of 88.0%and a specificity of 94.0%.Conclusion The expression level of miR-223 in ascites of patients with liver cirrhosis complicated with SBP is higher,and it is positively correlated with PCT and IL-6.MiR-223 is expected to be a marker for the diagnosis of liver cirrhosis complicated with SBP,and its combination with PCT can better diagnose liver cirrhosis complicated with SBP,and provides a new solution for clinical diagnosis of liver cirrhosis complicated with SBP.