外周血线粒体DNA、miR-223水平与脓毒症患者病情严重程度的关系及对预后的评估价值

Relationship between levels of peripheral blood mitochondrial DNA and miR-223 and severity of sepsis and their prognostic value

目的 探讨脓毒症患者外周血线粒体DNA、miR-223水平与病情严重程度的关系及对预后评估价值。方法 选取2018年1月-2020年9月唐山市工人医院收治98例脓毒症患者作为脓毒症组,根据病情严重程度分为单器官障碍组和多器官障碍组、休克组和非休克组,依据临床转归情况分为死亡组和存活组,另选46名健康体检者作为对照组,检测并比较受试者外周血线粒体DNA以及miR-223水平,同时分析其临床意义。结果 脓毒症组患者外周血线粒体DNA以及miR-223高于对照组(P<0.05);多器官障碍组两指标水平均高于单器官障碍组(P<0.05),休克组患者两指标水平高于非休克组(P<0.05);受试者工作特征(ROC)曲线显示,外周血线粒体DNA、miR-223水平及其联合用于评估患者多器官障碍曲线下面积(AUC)值分别为0.776、0.777、0.860,两指标单独及其联合用于评估脓毒症休克AUC值分别为0.717、0.644、0.773;死亡组患者外周血线粒体DNA、miR-223水平高于存活组(P<0.05),两指标单独及其联合用于预测患者临床转归AUC值分别为0.867、0.556、0.966。结论 脓毒症患者外周血线粒体DNA、miR-223水平与疾病严重程度和临床转归情况密切相关,两指标联合有助于提高其在疾病严重程度评估价值和临床转归预测价值。

OBJECTIVE To investigate the relationship between peripheral blood mitochondrial DNA and miR-223 levels and the severity of sepsis, and to evaluate their prognostic value. METHODS Total of 98 patients with sepsis admitted to Tangshan Workers’ Hospital during Jan 2018 to Sep 2020 were enrollled. According to severity of the disease, the patients were divided into the single-organ dysfunction group, multiple-organ dysfunction group, shock group and non-shock group. According to the clinical outcome, the patients were divided into the death group and survival group. The other 46 healthy volunteers were recruited in the control group. The peripheral blood mitochondrial DNA and miR-223 levels were detected and compared to analyze their clinical significance. RESULTS The peripheral blood mitochondrial DNA and miR-223 levels in the sepsis group were significantly higher than those in the control group(P<0.05). The levels of the two indicators in the multiple-organ dysfunction group were significantly higher than those in the single-organ dysfunction group(P<0.05), and the levels in the shock group were significantly higher than those in the non-shock group(P<0.05). The receiver operating characteristic(ROC) curves showed that the area under the curve(AUC) values of peripheral blood mitochondrial DNA, miR-223, and their combination to evaluate multiple-organ dysfunction were 0.776, 0.777, and 0.860, respectively. The AUC values for evaluating septic shock were 0.717, 0.644, and 0.773, respectively. Peripheral blood mitochondrial DNA and miR-223 levels in the death group were significantly higher than those in the survival group(P<0.05). The AUC values of two indicators alone and in combination for prognosis were 0.867, 0.556, and 0.966, respectively. CONCLUSION Peripheral blood mitochondrial DNA and miR-223 levels are closely related to the severity and clinical outcomes of sepsis. Combination of the two indicators is of high value in evaluating the severity of the disease and prognosis.