miR-27a表达水平与克罗恩病患者预后的相关性

Association between miR-27a Expression Level and Prognosis of Crohn's Disease Patients

【目的】探讨微小RNA-27a(miR-27a)表达水平与克罗恩病(CD)患者预后的相关性。【方法】回顾性分析2019年12月至2021年12月本院收治的147例CD患者的临床资料,根据随访结果将患者分为预后良好组(n=79)及预后不良组(n=68)。采用受试者工作特征(ROC)曲线分析miR-27a预测CD患者预后不良的价值;采用非条件Logistic逐步回归分析CD患者预后不良的危险因素。【结果】预后良好组确诊年龄>40岁、疾病类型是狭窄型及穿透型、有肛周病变的患者所占比例少于预后不良组(P<0.05),预后良好组治疗后miR-27a表达水平高于预后不良组(P<0.05)。ROC曲线分析显示,miR-27a表达水平预测CD患者预后不良的曲线下面积为0.954,95%CI为0.918~0.991,最佳截断值为0.335,敏感度为0.911,特异度为0.941,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,疾病类型为狭窄型及穿透型、有肛周病变、miR-27a≤0.335是CD患者预后不良的危险因素(P<0.05)。【结论】疾病类型为狭窄型及穿透型、肛周病变、miR-27a≤0.335是CD患者预后不良的危险因素,临床需密切关注此类患者。

【Objective】To investigate the correlation between the expression level of microRNA-27a(miR-27a)and the prognosis of Crohn's disease(CD).【Methods】A retrospective analysis was conducted on the clinical data of 147 patients with CD admitted to our hospital from December 2019 to December 2021.The patients were divided into a good prognosis group(n=79)and a poor prognosis group(n=68)based on follow-up results.The receiver operating characteristic(ROC)curve was used to analyze the value of miR-27a in predicting poor prognosis in CD patients;unconditional logistic stepwise regression was used to analyze the risk factors for poor prognosis in CD patients.【Results】The proportion of patients with age>40 years,disease type of stenosis and penetrating,and perianal lesions in the good prognosis group was lower than that in the poor prognosis group(P<0.05).The expression level of miR-27a after treatment in the good prognosis group was higher than that in the poor prognosis group(P<0.05).ROC curve analysis showed that the area under the curve for miR-27a expression level predicting poor prognosis in CD patients was 0.954(95%CI 0.918-0.991),with an optimal cutoff value of 0.335,sensitivity of 0.911,and specificity of 0.941(P<0.05).Multivariate logistic regression analysis showed that disease behavior of stenosis and penetrating,perianal lesions,and miR-27a≤0.335 were risk factors for poor prognosis in CD patients(P<0.05).【Conclusion】Stenosis and penetrating disease behavior,perianal lesions,and miR-27a≤0.335 are risk factors for poor prognosis in CD patients.Close attention should be paid to such patients in clinical practice.