miRNA-127-5p及sRAGE和IL-10预测重症肺炎临床转归不良的临床价值

Clinical values of miRNA-127-5p,sRAGE and IL-10 in prediction of adverse clinical outcomes of severe pneumonia patients

目的分析重症肺炎感染病原菌分布及微小核糖核酸(miRNA)-127-5p、可溶性晚期糖基化终产物受体(sRAGE)、白细胞介素-10(IL-10)预测重症肺炎临床转归不良的临床价值.方法选取2019年6月-2022年9月连云港市东方医院收治的299例重症肺炎患者,根据患者临床转归分为临床转归良好组235例,临床转归不良组64例.分析重症肺炎感染病原菌分布,采用受试者工作特征(ROC)曲线分析支气管肺泡灌洗液miRNA-127-5p相对表达量和外周血IL-10、sRAGE对重症肺炎临床转归不良的预测价值.结果299例重症肺炎患者临床转归不良64例,临床转归不良率为21.40%.共分离出病原菌342株,其中革兰阴性菌161株,占比为47.08%;临床转归不良组支气管肺泡灌洗液miRNA-127-5p相对表达量,血清IL-10、sRAGE水平均高于临床转归良好组(P<0.05);ROC曲线分析结果显示,miRNA-127-5p,IL-10、sRAGE预测重症肺炎患者临床转归不良的曲线下面积(AUC)分别为0.821、0.812、0.801.结论重症肺炎患者临床转归不良发生率较高,支气管肺泡灌洗液miRNA-127-5p相对表达量、血清IL-10、sRAGE水平对重症肺炎患者临床转归不良具有一定预测价值.

OBJECTIVE To investigate the distribution of pathogens isolated from the patients with severe pneumonia and analyze the clinical values of micro ribonucleic acid(miRNA)-127-5p,receptor for soluble advanced glycation end products(sRAGE)and interleukin-10(IL-10O)in prediction of adverse clinical outcomes.METHODS A total of 299 patients with severe pneumonia who were treated in Lianyungang Dongfang Hospital from Jun 2019 to Sep 2022 were enrolled in the study and were divided into the favorable clinical outcome group with 235 cases and the adverse clinical outcome group with 64 cases according to the clinical outcomes.The distribution of pathogens isolated form the patients with severe pneumonia was observed.The values of the relative expression level of bronchoalveolar lavage fluid(BALF)miRNA-127-5p and peripheral blood IL-10,sRAGE in prediction of adverse clinical outcomes were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS Among the 299 patients with severe pneumonia,64 had adverse clinical outcomes,with the incidence of adverse clinical outcomes 21.40%.Totally 342 strains of pathogens were isolated,161(47.08%)of which were gram-negative bacteria.The relative expression level of BALF miRNA-127-5p and serum IL-10,sRAGE levels were higher in the adverse clinical outcome group than in the favorable clinical outcome group(P<0.05).ROC curve analysis showed that the areas under curves(AUC)of miRNA-127-5p,IL-10 and sRAGE were respectively 0.821,0.812 and 0.801 in prediction of adverse clinical outcomes of the severe pneumonia patients.CONCLUSION The incidence of adverse clinical outcomes is high among the patients with severe pneumonia.The relative expression level of BALF miRNA-127-5p,serum IL-10 and sRAGE have certain values in prediction of adverse clinical outcomes of the severe pneumonia patients.