sICAM-1和miR-155与miR-141对糖尿病肾病血液透析并发血流感染的预测价值

Predictive value of sICAM-1,miR-155 and miR-141 on hemodialysis complicated with blood flow infection in diabetic nephropathy patients

目的研究血清可溶性细胞间黏附分子-1(sICAM-1)、外周血微小核糖核酸-155(miR-155)、微小核糖核酸-141(miR-141)对糖尿病肾病(DN)血液透析并发血流感染的预测价值及患者感染病原菌分布情况。方法选取2018年6月-2022年9月江南大学附属医院收治的119例DN血液透析并发血流感染患者作为B组,收集同期在医院接受治疗的132例DN血液透析未并发血流感染患者作为A组,统计两组一般资料,比较两组血清sICAM-1、外周血miR-155、miR-141表达情况,采用受试者工作特征(ROC)曲线分析血清sICAM-1、外周血miR-155、miR-141单独及联合对DN血液透析患者并发血流感染的预测价值,统计DN血液透析并发血流感染患者感染病原菌分布情况。结果B组血清sICAM-1、外周血miR-155、miR-141表达水平高于A组(P<0.05);血清sICAM-1、外周血miR-155、miR-141联合预测DN血液透析患者并发血流感染的曲线下面积(AUC)值高于三者单独预测(P<0.05),敏感度高于血清sICAM-1、外周血miR-141(P<0.05),特异度低于血清sICAM-1、外周血miR-141(P<0.05);DN血液透析并发血流感染患者革兰阴性菌占比63.71%,革兰阳性菌占比33.06%,真菌占比3.23%。结论血清sICAM-1、外周血miR-155、miR-141联合对DN血液透析患者并发血流感染具有较好的预测价值,同时DN血液透析并发血流感染患者主要感染病原菌种类较多。

OBJECTIVE To investigate the predictive value of serum soluble intercellular adhesion molecule-1(sI-CAM-1),micrornA-155(miR-155)and micrornA-141(miR-141)on hemodialysis blood flow infection in diabetic nephropathy(DN)patients and the distribution of pathogenic bacteria.METHODS From Jun 2018 to Sep 2022,119 patients with DN complicated with blood flow infection in the Affiliated Hospital of Jiangnan University were recruited and divided in to the group B,and the 132 DN patients treated in the hospital during the same period without concurrent blood flow infection were in the A group.The expressions of serum sICAM-1,peripheral blood miR-155 and miR-141 were compared between the two groups,and the predictive value of serum sICAM-1,pe-ripheral blood miR-155 and miR-141 alone and in combination in patients with DN undergoing hemodialysis was analyzed by receiver operating characteristic curve(ROC).The distribution of pathogenic bacteria in patients with DN complicated with hemodialysis was analyzed.RESULTS The expression levels of serum sICAM-1,miR-155 and miR-141 in peripheral blood in the group B were higher than those in the group A(P<0.05).The area under curve(AUC)value of combined detection of serum sICAM-1,miR-155 and miR-141 in peripheral blood on pre-diction was higher than that of the three alone(P<0.05),and the sensitivity was higher than that of serum sI-CAM-1 and miR-141 in peripheral blood(P<0.05).The specificity was lower than that of serum sICAM-1 and miR-141 in peripheral blood(P<0.05).In DN hemodialysis patients complicated with bloodstream infection,gram-negative bacteria accounted for 63.71%,gram-positive bacteria accounted for 33.06%and fungi accounted for 3.23%.CONCLUSION The combination of serum sICAM-1,peripheral blood miR-155 and miR-141 detection has a good predictive value in DN hemodialysis patients complicated with bloodstream infection,and many kinds of main infectious pathogens were detected in DN hemodialysis patients complicated with bloodstream infection.