外周血miR-10a和miR-29a水平对早期脓毒症急诊患者预后有预测作用

Predictive role of peripheral miR-10a and miR-29a levels in the prognosis of emergency patients with early sepsis

目的:探讨外周血miR-10a、miR-29a水平对早期脓毒症急诊患者预后的预测作用。方法:收集早期脓毒症急诊患者94例为观察组,选取同期82例健康体检者为对照组。其中观察组根据病情严重程度分为轻、中、重度3组。比较2组外周血miR-10a和miR-29a的表达水平,以及观察组不同预后患者治疗前miR-10a和miR-29a的表达水平。分析外周血miR-10a、miR-29a表达水平及miR-10a联合miR-29a检测对早期脓毒症急诊患者预后的预测价值。结果:观察组外周血miR-10a和miR-29a表达水平高于对照组(P均<0.05);观察组病情严重程度不同患者外周血miR-10a和miR-29a表达水平中,与轻度组比较,中度组和重度组患者表达水平升高,而重度组患者又显著高于中度组(P均<0.05);治疗1个月后,预后不良者18例,预后良好者治疗前外周血miR-10a和miR-29a的表达水平低于预后不良者(P均<0.05);miR-10a、miR-29a表达水平的最佳截断点分别为2.74和1.39,miR-10a、miR-29a两者联合检测的灵敏度、特异度和曲线下面积(AUC)均高于单独检测,分别为83.33%、85.53%和0.895。结论:早期脓毒症急诊患者外周血miR-10a、miR-29a表达水平均升高,可反应患者病情严重程度,两者联合检测预测早期脓毒症急诊患者的预后效能较高。

Objective:To investigate the predictive effect of peripheral blood miR-10a and miR-29a levels on the prognosis of early sepsis emergency patients.Methods:A total of 94 emergency patients with early sepsis were collected as the observation group,and 82 healthy people in the same period served as the control group.The observation group was divided into mild,moderate and severe subgroups according to the severity of the disease.The expression levels of miR-10a and miR-29a in the peripheral blood of the two groups,as well as the expression levels of miR-10a and miR-29a before treatment in patients with different prognosis in the observation subgroups were compared.The expression levels of miR-10a and miR-29a in peripheral blood and the prognostic value of miR-10a combined with miR-29a in early sepsis emergency patients were compared.Results:The expression levels of miR-10a and miR-29a in the peripheral blood of the observation group were higher than those in the control group(all P<0.05).The expression levels of miR-10a and miR-29a in peripheral blood of patients with different severity in the observation group were higher in moderate subgroup and severe subgroup than those in mild subgroup,and those in severe subgroup were significantly higher than those in moderate subgroup(all P<0.05).After 1 month of treatment,a total of 18 patients had a poor prognosis,and the expression levels of mir-10a and miR-29a in peripheral blood of patients with good prognosis were lower than those of patients with poor prognosis before treatment(all P<0.05).The optimal cutoff points of miR-10a and miR-29a expression levels were 2.74 and 1.39,respectively.The sensitivity,specificity and the area under the curve(AUC)of the combined detection of miR-10a and miR-29a were higher than those of the single detection,which were 83.33%,85.53%and 0.895,respectively.Conclusion:The expression levels of miR-10a and miR-29a in peripheral blood of emergency patients with early sepsis are increased and can reflect the severity and prognosis of patients.The combined detection of miR-10a and miR-29a can predict the prognosis of emergency patients with early sepsis.