血清miR-122a、MIF和HMGB1对儿童脓毒症并发肝损伤的预测价值

Values of serum miR-122a,MIF and HMGB1 in prediction of liver injury in children with sepsis

目的探究血清微小核糖核酸(miR)-122a、促黑激素释放抑制因子(MIF)和高迁移率族蛋白B1(HMGB1)对脓毒症患儿肝损伤的预测价值。方法选取海口市第三人民医院2016年1月-2023年9月收治的93例脓毒症合并肝损伤患儿纳入肝损伤组,208例未合并肝损伤患儿纳入非肝损伤组,收集患儿一般资料,Pearson相关性分析miR-122a、MIF、HMGB1水平与急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)评分、天冬氨酸氨基转移酶(AST)、丙氨酸转氨酶(ALT)、C3、C4水平的相关性,受试者工作特征(ROC)曲线分析miR-122a、MIF、HMGB1表达对脓毒症患儿肝损伤的诊断价值。结果肝损伤组APACHEⅡ评分、AST、ALT水平高于非肝损伤组(P<0.05),C3、C4水平低于非肝损伤组(P<0.05);肝损伤组miR-122a、MIF、HMGB1水平均高于非肝损伤组(P<0.05),且肝损伤越严重,水平升高越明显(P<0.05);Pearson相关性分析结果显示miR-122a、MIF和HMGB1与APACHEⅡ评分、AST及ALT均呈正相关(P<0.05),与C3、C4呈负相关(P<0.05);miR-122a、MIF和HMGB1联合诊断脓毒症患儿肝损伤的曲线下面积(AUC)值为0.916,敏感度为89.25%,特异度为80.29%。结论脓毒症患儿miR-122a、MIF和HMGB1水平在脓毒症肝损伤患儿中呈高表达,且三者与APACHEⅡ评分、AST、ALT、C3、C4水平具有相关性;miR-122a、MIF、HMGB1三者联合对脓毒症患儿肝损伤的诊断价值更高。

OBJECTIVE To explore the values of serum micro ribonucleic acid(miR)-122a,melanogen inhibiting factor(MIF)and high mobility group protein B1(HMGB1)in prediction of liver injury in the children with sepsis.METHODS A total of 93 sepsis children who were complicated with liver injury and were treated in the Third People′s Hospital of Haikou City from Jan 2016 to Sep 2023 were assigned as the liver injury group,and 208 children who were not complicated with liver injury were assigned as the non-liver injury group.The baseline data were collected from the children.Pearson correlation analysis was performed for the association between the levels of miR-122a,MIF and HMGB1 and the acute physiology and chronic health evaluation II(APACHEII)score,aspartate transaminase(AST),alanine aminotransferase(ALT),C3 and C4 levels.The values of miR-122a,MIF and HMGB1 in diagnosis of liver injury in the spies children were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS The APACHEII score,AST level and ALT level of the liver injury group were significantly higher than those of the non-liver injury group(P<0.05),the levels of C3 and C4 of the liver injury group were significantly lower than those of the non-liver injury group(P<0.05).The levels of miR-122a,MIF and HMGB1 of the liver injury group were significantly higher than those of the non-liver injury group(P<0.05);the more severe the liver injury,the higher the levels of the indexes(P<0.05).The result of Pearson correlation analysis showed that the miR-122a,MIF and HMGB1 were positively correlated with the APACHEII score,AST and ALT(P<0.05)but were negatively correlated with the C3 and C4(P<0.05).The area under curve(AUC)of the joint detection of miR-122a,MIF and HMGB1 was 0.916 in diagnosis of the liver injury in the sepsis children,with the sensitivity 89.25%,the specificity 80.029%.CONCLUSION The sepsis children with liver injury show the high expressions of miR-122a,MIF and HMGB1,and the three indexes are associated with the APACHEII score,AST,ALT,C3 and C4.