外周血miRNA-146a、miRNA-26a在重症急性胰腺炎预后中的价值探讨

The values of miR-146a and miR-26a in peripheral blood of evaluating prognosis of severe acute pancreatitis

目的 探究外周血微小RNA-146a(miR-146a)、微小RNA-26a(miR-26a)在重症急性胰腺炎预后中的价值。方法 选择器工业五二一医院2019年4月—2021年3月收治的119例重症急性胰腺炎患者作为研究对象,根据临床病历资料收集患者的临床一般资料,于患者入院24 h内对患者外周血miRNA-146a、miRNA-26a相对表达量及血常规指标进行检测。根据患者治疗28 d内病情转归情况将其分为生存组和死亡组。通过Logistic多因素回归分析影响重症急性胰腺炎患者预后的影响因素;采用受试者工作特征曲线(ROC)下面积评估外周血miR-146a及miR-26a水平对患者临床预后的预测价值。结果 死亡组胰周感染所占比例及APACHEⅡ评分、miR-146a相对表达量、miR-26a相对表达量均高于生存组,差异有统计学意义(P<0.05)。Logistic多因素回归分析结果显示,胰周感染、APACHEⅡ评分、外周血miR-146a及miR-26a相对表达水平偏高均为重症急性胰腺炎患者预后死亡的危险因素(P<0.05)。ROC分析显示,外周血miR-146a、miR-26a水平单一及联合对重症急性胰腺炎患者预后死亡的ROC预测的曲线下面积(AUC)分别为0.793、0.780、0.883,且外周血miR-146a、miR-26a水平对重症急性胰腺炎患者死亡预后的单一预测效能低于两者联合(P<0.05)。结论 合并胰周感染、APACHEⅡ评分、外周血miR-146a及miR-26a相对表达水平偏高的重症急性胰腺患者死亡率较高,外周血miR-146a、miR-26a相对表达水平均可有效预测重症急性胰腺炎患者的死亡预后。

Objective To explore the values of peripheral blood microRNA-146a(miR-146a) and microRNA-26a(miR-26a) inevaluatingthe prognosis of severe acute pancreatitis.Methods A total of 119 patients with severe acute pancreatitis who were admitted to our hospital from April 2019 to March 2021 were selected as the research subjects,and the general clinical data of the patients were collected according to the clinical medical records.The relative expression of microRNA-26a and blood routine indexes were detected.The patients were divided into a survival group and a death group according to their disease outcomes within 28 days of treatment.Logistic multivariate regression analysis was used to analyze the influencing factors for the prognosis of patients with severe acute pancreatitis;the area under the rreceiver operating characteristic curve was used to evaluate the predictive value of peripheral blood miR-146a and miR-26a levels on the clinical prognosis of patients.Results The proportion of peripancreatic infection,APACHE Ⅱ score,relative expression of miR-146a,and relative expression of miR-26a in the death group were all significantly higher than those in the survival group(all P<0.05).Logistic multivariate regression analysis showed that peripancreatic infection,APACHE Ⅱ score,and relatively high expression levels of miR-146a and miR-26a in peripheral blood were all risk factors for the prognosis of death in the patients with severe acute pancreatitis(all P<0.05).ROC analysis showed that area under the curve of single peripheral blood miR-146a,single peripheral blood miR-26a,and the combined miR-146a and miR-26a ROC.for the prognostic death of patients with severe acute pancreatitis were0.793,0.780,and 0.883 respectively,and the single predictive power of peripheral blood miR-146a level or miR-26a levelwere both significantly lower than that of the combination of the two(both P<0.05).Conclusion Severe acute pancreatic patients with peripancreatic infection,high APACHE Ⅱ score,and high relative expression levels of miR-146a and miR-26a in peripheral blood have a higher mortality rate.The relative expression levels of miR-146a and miR-26a in peripheral blood can effectively predict severe prognosis of death.