急性胰腺炎患者血清miR-455-3p,miR-141-3p水平表达与病情严重程度的关系研究

Study on the Relationship between the Expression of Serum miR-455-3p and miR-141-3p Levels and the Severity of Disease in Patients with Acute Pancreatitis

目的 探讨急性胰腺炎(acute pancreatitis,AP)患者血清miR-455-3p,miR-141-3p水平表达与病情严重程度的关系。方法 选取2021年11月~2023年11月于都江堰市人民医院就诊的AP患者133例(AP组)作为研究对象;根据病情程度将AP患者分为重症组(n=43)和轻症组(n=90)。同期选取于该院体检健康者135例作为对照组。实时荧光定量PCR(RT-q RCR)法检测血清miR-455-3p和miR-141-3p水平。Spearman相关性分析血清miR-455-3p,miR-141-3p水平与急性生理与慢性健康评分Ⅱ(acute physiology and chronic health evaluation Ⅱ,APACHE Ⅱ)、Ranson评分的相关性;受试者工作特征(ROC)曲线分析血清miR-455-3p,miR-141-3p水平对重症AP的诊断价值;多因素Logistics回归分析影响重症AP的发生因素。结果 AP组血清miR-455-3p(0.61±0.13)低于对照组(1.12±0.21),miR-141-3p水平(1.37±0.11)高于对照组(1.04±0.15),差异具有统计学意义(t=23.863,20.513,均P<0.05)。重症组患者血清miR-455-3p水平(0.53±0.10)低于轻症组(0.64±0.12),miR-141-3p水平(1.51±0.14)高于轻症组(1.30±0.15),差异具有统计学意义(t=6.056,7.713,均P<0.05)。重症组患者血清淀粉酶(serum amylase,AMS)、脂肪酶(lipase,LPS)水平及APACHEⅡ,Ranson评分高于轻症组,差异具有统计学意义(t=2.227,2.290,18.267,11.259,均P <0.05)。Spearman相关性分析结果表明,AP患者血清miR-455-3p与APACHEⅡ,Ranson评分呈负相关(r=-0.702,-0.783,均P <0.05),miR-141-3p与APACHEⅡ,Ranson评分呈正相关(r=0.787,0.734,均P <0.05)。ROC曲线结果表明血清miR-455-3p,miR-141-3p水平单独及联合诊断重症AP的AUC分别为0.848,0.822和0.919,且二者联合诊断优于单独诊断(Z=3.081,2.524,均P<0.05)。多因素Logistic回归分析结果显示miR-455-3p是影响重症AP的保护因素,miR-141-3p是影响重症AP的危险因素(P<0.05)。结论 AP患者血清miR-455-3p下降和miR-141-3p升高与病情严重程度密切相关。

Objective To investigate the relationship between the expression of miR-455-3p and miR-141-3p levels in serum and the severity of acute pancreatitis(AP)in patients.Methods A total of 133 AP patients(AP group)who visited the People’s Hospital of Dujiangyan from November 2021 to November 2023 were regarded as the study subjects.According to the severity of disease,AP patients were separated into a severe group(n=43)and a mild group(n=90).During the same period,135 healthy individuals who underwent physical examination in the hospital were regarded as the control group.Real-time fluorescence quantitative PCR method was applied to detect serum levels of miR-455-3p and miR-141-3p.Spearman correlation analysis was applied to analyze the correlation between serum miR-455-3p and miR-141-3p levels and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)and Ranson scores.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum miR-455-3p and miR-141-3p levels for severe AP.Multivariate logistic regression was applied to analyze the factors affecting the occurrence of severe AP.Results The serum miR-455-3p level(0.61±0.13)in the AP group was lower than that in the control group(1.12±0.21),while the miR-141-3p level(1.37±0.11)was higher than that in the control group(1.04±0.15),with significant differences(t=23.863,20.513,all P<0.05).The serum miR-455-3p level(0.53±0.10)in the severe group was lower than that in the mild group(0.64±0.12),while the miR-141-3p level(1.51±0.14)was higher than that in the mild group(1.30±0.15),with significant differences(t=6.056,7.713,all P<0.05).The serum amylase(AMS),lipase(LPS)levels,APACHE II and Ranson scores in the severe group were higher than those in the mild group,and the differences were significant(t=2.227,2.290,18.267,11.259,all P<0.05).Spearman correlation analysis results showed that the serum miR-455-3p of AP patients was negatively correlated with APACHEII and Ranson scores(r=-0.702,-0.783,all P<0.05),while miR-141-3p was positively correlated with APACHEII and Ranson scores(r=0.787,0.734,all P<0.05).ROC curve results showed that the AUCs of serum miR-455-3p and miR-141-3p levels alone and combination of severe AP were 0.848,0.822 and 0.919,respectively.And the combination detection was superior to single detection(Z=3.081,2.524,all P<0.05).Multivariate Logistic regression analysis showed that miR-455-3p was a protective factor affecting severe AP,while miR-141-3p was a risk factor affecting severe AP(P<0.05).Conclusion The decrease of serum miR-455-3p and the increase of miR-141-3p in AP patients are closely related to the severity of disease.