慢性萎缩性胃炎患者血清miR-122-5p水平与炎症因子、疾病严重程度的相关性研究

Correlation of serum miR-122-5p level with inflammatory factors and disease severity in elderly patients with chronic atrophic gastritis

目的研究慢性萎缩性胃炎(chronic atrophic gastritis,CAG)患者血清微小RNA-122-5p(miR-122-5p)表达水平及其与炎症因子、疾病严重程度的相关性。方法选择2019年12月~2021年12月在山西省人民医院收治的CAG患者120例为观察对象,根据胃黏膜病理评分将患者分为病情一般58例和病情严重62例,另选择同期慢性非萎缩性胃炎患者105例作为对照组。采用qRT-PCR法检测血清miR-122-5p表达水平,免疫比浊法检测血清hs-CRP水平,酶联免疫吸附(ELISA)法检测血清TNF-α、IL-6水平;Pearson法分析CAG患者血清miR-122-5p表达水平与hs-CRP、IL-6、TNF-α及病情严重程度的相关性;Logistic回归分析影响CAG的危险因素。结果CAG组与对照组之间性别、年龄、及吸烟史等比较,差异无统计学意义(P>0.05);CAG组饮酒及Hp阳性比例分别为(52.50%、62.50%),显著高于对照组(25.71%、43.80%)(P<0.05);CAG组血清miR-122-5p、hs-CRP、IL-6、TNF-α水平分别为[(2.31±0.42)、(24.89±4.56)mg/L、(39.26±7.68)ng/ml、(85.42±9.65)pg/ml],显著高于对照组[(1.05±0.12)、(16.54±3.85)mg/L、(22.39±5.21)ng/ml、(862.34±7.46)pg/ml](P<0.05);CAG病情严重患者血清hs-CRP、IL-6、TNF-α水平、miR-122-5p表达水平Hp阳性感染率及病理评分分别为[(28.14±3.21)mg/L、(44.55±5.73)ng/ml、(93.42±8.81)pg/ml、(2.74±0.30)、72.58%、(4.30±1.20)分],显著高于病情一般患者[(21.42±3.67)mg/L、(33.61±5.54)ng/ml、(76.87±7.59)pg/ml、(1.85±0.36)、51.72%、(1.60±0.30)分](P<0.05)。相关性分析显示,CAG患者血清miR-122-5p表达水平与hs-CRP、IL-6、TNF-α及病情程度呈正相关性(r=0.475、0.453、0.505、0.563,P<0.01);多因素Logistic分析显示,Hp阳性感染(0R=2.527,95%CI=1.125~5.678)、miR-122-5p(OR=2.323,95%CI=1.341~4.025)是影响CAG的独立危险因素(P<0.05)。结论CAG患者血清miR-122-5p表达水平升高,与患者血清炎症因子、疾病严重程度和Hp感染有关,可能成为诊断CAG的标志物。

Objective To investigate the expression level of serum microRNA-122-5p(miR-122-5p)in elderly patients with chronic atrophic gastritis(CAG)and its correlation with inflammatory factors and disease se-verity.Methods A total of 120 CAG patients admitted to our hospital from Dec.2019 to Dec.2021 were selected as as the experimental group.According to the gastric mucosa pathological score,the patients were grouped into 58 cases with normal condition and 62 cases with severe condition.Another 105 patients with chronic non-atrophic gastritis during the same period were included as the control group.The expression level of serum miR-122-5p was detected by qRT-PCR,the level of serum hs-CRP was detected by immunoturbidimetry,the levels of serum TNF-α and IL-6 were detected by enzyme-linked immunosorbent assay(ELISA),and the correlation of serum miR-122-5p expression level with hs-CRP,IL-6,TNF-αand disease severity in CAG patients was analyzed by Pearson method.Logistic regression was used to analyze the risk factors of affecting CAG.Results There were no significant differences in gender,age,or the proportion of patients with smoking history between the CAG group and the control group(P>0.05).The proportions of drinking and Hp positive patients in the CAG group were 52.50%and 62.50%,which were significantly higher than those in the control group(25.71%,43.80%)(P<0.05);The serum levels of miR-122-5p,hs-CRP,IL-6,and TNF-α in the CAG group were(2.31±0.42),(24.89±4.56)mg/L,(39.26±7.68)ng/mL,and(85.42±9.65)pg/ml,respectively,which were significantly higher than the control group[(1.05±0.12),(16.54±3.85)mg/L,(22.39±5.21)ng/ml,(862.34±7.46)pg/ml](P<0.05);Serum hs-CRP,IL-6,TNF-α levels,miR-122-5p expression levels,Hp positive infection rate and pathological score in patients with severe CAG disease were(28.14±3.21)mg/L,(44.55±5.73)ng/ml,(93.42±8.81)pg/ml,2.74±0.30,72.58%,(4.30±1.20)points,respectively,which were significantly higher than those of patients with normal disease[(21.42±3.67)mg/L,(33.61±5.54)ng/ml,(76.87±7.59)pg/mL,1.85±0.36,51.72%,(1.60±0.30)points](P<0.05);correlation analysis showed that serum miR-122-5p expression level in CAG patients was positively correlated with hs-CRP,IL-6,TNF-α and disease severity(r=0.475,0.453,0.505,0.563,P<0.001).Multivariate logistic analysis showed that Hp positive infection(OR=2.527,95%CI=1.125-5.678),miR-122-5p(OR=2.323,95%CI=1.341-4.025)were independent risk factors for CAC(P<0.05).Conclusion The expression level of serum miR-122-5p in elderly patients with CAG is increased,which is related to serum inflammatory factors,disease severity and Hp infection,and may be a marker for the diagnosis of CAG.