血清lncNEAT1和sTREM-2在SAE老年患者中的表达及临床意义

Expression and clinical significance of serum long chain non-coding RNA NEAT1 and sTREM-2 in elderly patients with SAE

目的研究脓毒症相关性脑病(SAE)老年患者血清长链非编码RNA核富含丰富的转录本1(lncNEAT1)和可溶性髓样细胞触发受体-2(sTREM-2)的表达及临床意义。方法选取2018年1月至2021年1月于该院诊治的224例脓毒症老年患者分为SAE组(合并SAE,84例)和对照组(未并发脑损伤,140例)。根据28 d生存情况,将SAE组分为存活组(44例)和死亡组(40例)。荧光定量PCR检测血清lncNEAT1水平,酶联免疫吸附试验检测血清sTREM-2水平。多因素Logistic回归分析影响SAE老年患者生存预后的因素。受试者工作特征曲线分析各指标对SAE老年患者生存预后的诊断价值。结果SAE组血清lncNEAT1(4.68±0.79 vs.2.03±0.37)、sTREM2[(25.14±4.34)pg/mL vs.(11.40±3.71)pg/mL]高于对照组,差异均有统计学意义(t=27.285、21.743,均P<0.05)。SAE老年患者血清lncNEAT1、sTREM2水平与降钙素原(PCT)、中枢神经特异性蛋白(S100β)、人神经元特异性烯醇化酶(NSE)、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、序贯器官衰竭评分(SOFA评分)均呈正相关(r=0.451~0.674,均P<0.05)。血清lncNEAT1、sTREM2升高是影响SAE老年患者不良生存预后的独立危险因素。血清lncNEAT1、sTREM2联合检测评估SAE老年患者生存预后的曲线下面积为0.874,显著高于血清lncNEAT1、sTREM2单一指标,曲线下面积为0.797、0.820(Z=3.864、3.872,均P<0.05)。结论SAE老年患者血清lncNEAT1、sTREM2表达升高,是影响老年SAE生存预后的独立危险因素。

Objective To study the expression of serum long chain non-coding RNA nucleiare rich in transcripts 1(lncNEAT1)and soluble triggering receptor expressed on myeloid cell 2(sTREM-2)in elderly patients with sepsis associated encephalopathy(SAE)and their clinical significance.Methods Two hundred and twenty-fourelderly sepsis patients diagnosed and treated in Hainan Province Geriatric Hospital from January 2018 to January 2021 were selected,and they were divided into an SAE group of 84 cases(with SAE)and a control group of 140 cases(without brain injury).According to the 28 d survival status,the SAE group was divided into a survival group of 44 cases and a death group of 40 cases.The expression of lncNEAT1 in serum was detected by fluorescent quantitative PCR,and the expression of sTREM-2 in serum was detected by enzyme-linked immunosorbent assay.Multivariate Logistic regression analysis was used to analyze the factors influencing the survival and prognosis of SAE patients.The diagnostic value of each index for survival and prognosis of SAE patients was analyzed by receiver operating curve.Results The serum levels of lncNEAT1(4.68±0.79 vs.2.03±0.37)and sTREM2[(25.14±4.34)pg/mL vs.(11.40±3.71)pg/mL]in the SAE group were significantly higher than those in the control group(t=27.285,21.743,both P<0.05).Serum levels of lncNEAT1,sTREM2 and procalcitonin(PCT),central neuron specific proteins(S100β)in patients with SAE,neuron-spectic enolase(NSE),acute physiologyunal chronicheaith score(APACHEⅡ)scores,and sequential organ failure(SOFA)scores were positively correlated(r=0.451 to 0.674,all P<0.05).Elevated serum levels of lncNEAT1 and sTREM2 were independent risk factors for poor survival and prognosis in patients with SAE.The area under the curve of the combined test of serum lncNEAT1 and sTREM2 for evaluating the survival and prognosis of SAE patients was 0.874,significantly higher than that of serum lncNEAT1 and sTREM2,which were 0.797 and 0.820(Z=3.864 and 3.872,both P<0.05).Conclusion The increased expression of lncNEAT1 and sTREM2 in serum of SAE patients are independent risk factors affecting the survival and prognosis of elderly SAE patients.