血清miR-128-3p在脓毒症并发急性肾损伤患儿中的表达及其判断预后的价值

Expression of serum miR-128-3p in children with sepsis complicated with acute kidney injury and its prognostic value

目的探讨血清miR-128-3p在脓毒症并发急性肾损伤(AKI)患儿中的表达及在其预后判断中的价值.方法选取2018年1月至2020年6月本院收治的脓毒症并发AKI患儿120例,根据其28 d的生存情况分为生存组(82例)和死亡组(38例),检测两组的血清miR-128-3p、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)及肾损伤分子-1(KIM-1)水平.应用多因素logistic回归分析脓毒症并发AKI患儿发生死亡的危险因素.绘制受试者工作特征(ROC)曲线分析血清miR-128-3p、NGAL及KIM-1水平判断脓毒症并发AKI患儿死亡的价值.结果死亡组的血清miR-128-3p、NGAL及KIM-1水平均明显高于生存组(均P<0.001).多因素logistic回归分析显示,血清miR-128-3p、NGAL及KIM-1水平升高是脓毒症并发AKI患儿死亡的独立危险因素(均P<0.001).ROC曲线分析显示,血清miR-128-3p、NGAL及KIM-1三项联合判断脓毒症并发AKI患儿死亡的ROC曲线下面积(0.950,95%CI:0.894~0.993)最大,其灵敏度为96.2%,特异度为90.4%.结论脓毒症并发AKI患儿的血清miR-128-3p表达水平明显升高,联合NGAL、KIM-1检测有助于判断AKI患儿的预后.

Objective To investigate the expression of miR-128-3p in children with sepsis complicated with acute kidney injury(AKI)and its prognostic value.Methods The 120 children with sepsis complicated with AKI admitted to the our hospital from January 2018 to May 2020 were divided into survival group(n=82)and death group(n=38)according to their 28 day survival.The levels of serum miR-128-3p,neutrophil gelatinase-related lipid carrier protein(NGAL)and kidney injury molecule-1(KIM-1)were detected in the two groups.Multivariate logistic regression was used to analyze the risk factors of death in children with sepsis complicated with AKI.Receiver operating characteristic(ROC)curve was drawn to analyze the value of serum miR-128-3p,NGAL and KIM-1 levels in judging the death of children with sepsis complicated with AKI.Results Serum miR-128-3p,NGAL and KIM-1 levels in the death group were significantly higher than those in the survival group,with statistical significance(all P<0.001).Multivariate logistic regression analysis showed that elevated serum miR-128-3p,NGAL and KIM-1 levels were independent risk factors for death in sepsis complicated with AKI(all P<0.001).ROC curve analysis showed that the area under ROC curve(0.950,95%CI:0.894-0.993)of serum miR-128-3p,NGAL and KIM-1 combined to determine the death of children with sepsis complicated with AKI was the largest.Conclusions The expression level of serum miR-128-3p was significantly increased in children with sepsis complicated with AKI,and the combination of NGAL and KIM-1 detection is helpful to determine the prognosis of children with AKI.