miR-26a-5p在重症脑梗死合并医院感染早期预测中的价值

Values of miR-26a-5p in early prediction of nosocomial infection in patients with severe cerebral infarction

目的分析血清微小RNA(miR)-26a-5p在重症急性脑梗死(ACI)患者合并医院感染早期预测中的价值。方法选取2018年10月-2019年9月在辽宁省大连市中心医院神经内科住院的200例重症ACI患者为研究对象,根据是否发生医院感染分为感染组56例和非感染组144例。分析两组患者基础资料及入院24 h外周血miR-26a-5p、降钙素原(PCT)、C-反应蛋白(CRP)、白细胞计数(WBC)、红细胞沉降率(ESR)水平。结果感染组患者合并糖尿病比例及入院时美国国立卫生研究院卒中量表(NIHSS)评分、急性生理学及慢性健康状况评分系统(APACHE-Ⅱ)评分均高于非感染组(P<0.05),格拉斯哥昏迷指数(GCS)评分低于非感染组(P<0.05)。感染组患者入院24h miR-26a-5p相对表达量和血清PCT水平分别为(7.01±2.51)和(1.94±0.59)μg/L,均高于非感染组(P<0.05)。miR-26a-5p、PCT早期预测重症ACI患者合并医院感染的受试者工作特征(ROC)曲线下面积分别为0.844和0.753。结论重症ACI患者入院早期miR-26a-5p相对表达量的升高可提示其医院感染风险较高,可将其与PCT等实验室指标进行联合应用,以提高针对医院感染的预测效率。

OBJECTIVE To analyze the value of serum microRNA(miR)-26 a-5 p in early prediction of nosocomial infection in patients with severe acute cerebral infarction(ACI).METHODS A total of 200 patients with severe ACI who were hospitalized in neurology department of Dalian Central Hospital of Liaoning Province from Oct 2018 to Sep 2019 were recruited as the study objects and divided into the infection group with 56 cases and the no infection group with 144 cases according to the status of nosocomial infection.The baseline data of the two groups of patients were analyzed,and the levels of peripheral blood miR-26 a-5 p,procalcitonin(PCT),C-reactive protein(CRP),white blood cell(WBC)and erythrocyte sedimentation rate(ESR)were observed and compared between the two groups of patients after the admission for 24 hours.RESULTS The proportion of patients complicated with diabetes mellitus,national institute of health stroke scale(NIHSS)score and acute physiology and chronic health evaluation scoring system(APACHE-Ⅱ)score at the admission were significantly higher in the infection group than in the no infection group(P<0.05);the Glasgow coma scale(GCS)score of the infection group was significantly lower than that of the no infection group(P<0.05).The relative expression level of miR-26 a-5 p and serum PCT level of the infection group were respectively(7.01±2.51)and(1.94±0.59)μg/L after hospitalization for 24 hours,significantly higher than those of the no infection group(P<0.05).The areas under receiver operating characteristic(ROC)curves of miR-26 a-5 p and PCT were respectively 0.844 and 0.753 in early prediction of nosocomial infection in the patients with severe ACI.CONCLUSION The rise of relative expression level of miR-26 a-5 p indicates the high risk of nosocomial infection in the patients with severe ACI in early stage of hospitalization,and its combination with laboratory test indexes such as PCT may raise the predictive efficiency of nosocomial infection.