血清LncRNA NEAT1对脓毒血症并发急性肾损伤的预测价值

The Value of serum LncRNA NEAT1 in Predicting Acute Kidney Injury in Patients with Sepsis

目的 探讨血清中lncRNA NEAT1表达对脓毒血症并发急性肾损伤(acute kidney injury,AKI)的诊断价值。方法 选取2018年5月~2021年5月深圳市龙华区人民医院重症医学科收治的脓毒血症患者163例,收集临床资料,qRT-PCR检测血清中核富含丰富的转录本1(nuclear enriched abundant transcript 1,NEAT1)表达,采用受试者工作特征曲线(ROC)分析血清中NEAT1表达量在预测患者发生AKI中的价值。结果 163例脓毒血症患者中,67例发生AKI(AKI组),发生率41.10%,其余作为对照组;2组患者在发病至入重症监护室(intensive care unit,ICU)时间、序贯器官衰竭评分(sequential organ failure assessment,SOFA)评分、血肌酐(serum creatinine,Scr)、乳酸、估算肾小球滤过率(estimated glomerular filtration rate,eGFR)、输注血浆和输注红细胞(red blood cell,RBC)差异有统计学意义(t=8.698、8.134、13.978、2.383、4.177、6.609、2.453,P<0.001、<0.001、<0.001、0.018、<0.001、<0.001、0.015);AKI组患者血清中NEAT1相对表达量高于对照组(t=9.314,P<0.001);Logistic回归分析结果显示:Scr(OR=1.263,95%CI:1.052~1.515,P=0.012)、输注血浆(OR=1.063,95%CI:1.007~1.122,P=0.026)和NEAT1表达(OR=4.897,95%CI:1.392~17.233,P=0.013)是影响脓毒血症患者发生AKI的危险因素;ROC曲线分析结果显示:血清中NEAT1表达量在预测脓毒血症并发AKI时曲线下面积为0.853(95%CI:0.796~0.910),当血清中NEAT1表达量为1.60时,灵敏度为88.06%,特异度为64.58%。结论 浓毒血症并发AKI患者血清中NEAT1表达量升高,是脓毒血症患者发生AKI的风险因素,对患者发生AKI的具有一定的预测价值。

Objective To investigate the value of serum LncRNA NEAT1 in predicting acute kidney injury(AKI) in patients with sepsis. Methods A total of 163 cases of patients with sepsis admitted to the Department of Intensive Care Medicine in our hospital were selected from May 2018 to May 2021. The expression of nuclear enriched abundant transcript 1(NEAT1) in the serum was detected by using qRT-PCR. The value of the expression of NEAT1 in the serum in predicting the occurrence of AKI in patients with sepsis was analyzed by using receiver operating characteristic curve(ROC). Results Among 163 cases of patients with sepsis, 67 cases occurred AKI(AKI group), with an incidence rate of 41.10%, and the rest seemed as the control group. The differences of the time from onset to intensive care unit(ICU) admission, sequential organ failure assessment(SOFA) score, serum creatinine(Scr), lactate, estimated glomerular filtration rate(eGFR), plasma infusion and red blood cell(RBC) infusion between the two groups were statistically significant(t=8.698,P<0.001;t =8.134, P<0.001;t=13.978, P<0.001;t=2.383, P=0.018;t=4.177, P<0.001;t=6.609, P<0.001and t=2.453, P=0.015). The relative expression level of NEAT1 in the serum in the AKI group was 1.90±0.26,which was higher than 1.46±0.32 in the control group, and the difference was statistically significant(t=9.314,P<0.001). Logistic regression analysis showed that Scr, plasma infusion and the expression of NEAT1 were risk factors for AKI occurring in patients with sepsis(OR=1.263, 95% CI=1.052~1.515, P=0.012;OR=1.063,95% CI=1.007~1.122, P=0.026;OR=4.897, 95% CI=1.392~17.233, P=0.013). ROC curve analysis results showed that the area under the curve of the expression of NEAT1 in serum for predicting the occurrence of AKI in patients with sepsis was 0.853(95% CI: 0.796~0.910). When the expression level of NEAT1 in serum was 1.60, the sensitivity was 88.06%, and the specificity was 64.58%. Conclusion The expression level of NEAT1 in the serum of patients with sepsis complicated with AKI is increased. It is a risk factor for AKI occurring in patients with sepsis, and it has certain predictive value for the occurrence of AKI in patients.