血清miR-483-5p miR-487b表达与脓毒症所致急性肺损伤患者炎性因子病情和预后的关系研究

doi:10.3969/j.issn.1006-6233.2022.09.015

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摘要 目的: 探讨miR-483-5p、miR-487b与脓毒症所致急性肺损伤(ALI)患者炎性因子、病情和预后的关系。方法: 选择2018年9月至2021年12月我院收治的133例脓毒症患者,51例合并ALI(ALI组),82例未合并ALI(NALI组),根据氧合指数[(氧分压/吸入气氧浓度]将ALI组分为轻度组(201~300mmHg)16例、中度组(101~200mmHg)20例和重度组(≤100mmHg)15例,根据ALI组28d生存状况分为生存组(28例)、死亡组(23例),另选择43例志愿者为对照组。比较不同分组血清miR-483-5p、miR-487b表达与炎性因子水平差异,Pearson分析脓毒症合并ALI患者miR-483-5p、miR-487b表达与炎性因子水平相关性,受试者工作特征曲线(ROC)分析miR-483-5p、miR-487b预测脓毒症所致ALI患者预后的价值。结果: ALI组基线血清miR-483-5p表达,白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-33(IL-33)水平高于NALI组和对照组(P<0.05),miR-487b表达低于NALI组和对照组(P<0.05)。重度组基线、住院3d、住院7d血清miR-483-5p表达,IL-6、TNF-α、IL-33水平高于中度组和轻度组(P<0.05),miR-487b表达低于中度组和轻度组(P<0.05)。死亡组基线、住院3d、住院7d血清miR-483-5p表达,IL-6、TNF-α、IL-33水平高于生存组(P<0.05),miR-487b表达低于生存组(P<0.05)。脓毒症所致ALI患者基线、住院3d、住院7d血清miR-483-5p表达与基线、住院3d、住院7d IL-6、TNF-α、IL-33水平呈正相关(P<0.05),基线、住院3d、住院7d miR-487b表达与基线、住院3d、住院7d IL-6、TNF-α、IL-33水平呈负相关(P<0.05)。联合住院7d miR-483-5p和miR-487b预测脓毒症所致ALI的曲线下面积为0.964,高于单独miR-483-5p、miR-487b预测(z=2.612、3.141,P<0.05)。结论: 脓毒症所致ALI患者血清miR-483-5p表达上调,miR-487b表达下调,且与过度炎症反应,病情加重和不良预后有关。

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关键词 ：脓毒症, 急性肺损伤, 炎性因子, 预后, 微小核糖核酸, miR-483-5p, miR-487b

Abstract：Objective: To investigate the relationship between miR-483-5p and miR-487b and inflammatory factors, disease condition, and prognosis in patients with acute lung injury (ALI) induced by sepsis. Methods: A total of 133 sepsis patients admitted to the ICU of our hospital from September 2018 to December 2021 were selected, including 51 cases complicated with ALI (ALI group) and 82 cases without ALI (NALI group). According to oxygenation index [oxygen partial pressure/inhaled oxygen concentration], ALI group was divided into mild group (201 ~ 300mmHg) (16 cases), moderate group (101 ~ 200mmHg) (20 cases) and severe group (≤100mmHg) (15 cases). According to the 28-day survival status, the ALI group was divided into the survival group (28 cases) and the death group (23 cases). Another 43 volunteers were selected as the control group. The serum expressions of mir-483-5p and mir-487b and the levels of inflammatory factors in different groups were compared. Pearson analyzed the correlation between the expressions of miR-483-5p and miR-487b and the levels of inflammatory factors in patients with sepsis complicated with ALI. Receiver operating characteristic curve (ROC) analysis of the prognostic value of miR-483-5p and miR-487b in patients with sepsis-induced ALI. Results: The expression of miR-483-5P, the levels of interleukin-6 (IL-6), tumor necrosis factor -α (TNF-α), and interleukin-33 (IL-33) on the baseline in the ALI group were higher than those in NALI group and control group (P<0.05), and the expression of miR-487b on the baseline was lower than those in NALI group and control group (P<0.05). The expression of miR-483-5p, IL-6, TNF-α, and IL-33 on the baseline, 3d hospitalization, and 7d hospitalization in the severe group were higher than those in the moderate and mild groups (P<0.05), and the expression of miR-487b was lower than those in the moderate and mild groups (P<0.05). Serum miR-483-5p expression, IL-6, TNF-α, IL-33 levels on the baseline, 3d hospitalization, and 7d hospitalization in the death group were higher than those in the survival group (P<0.05), and miR-487b expression was lower than those in the survival group (P<0.05). The expression of miR-483-5P was positively correlated with the levels of IL-6, TNF-α, and IL-33 on the baseline, 3d hospitalization, and 7d hospitalization in patients with sepsis (P<0.05). The expression of miR-487b was negatively correlated with the levels of IL-6, TNF-α, and IL-33 on the baseline, 3d hospitalization, and 7d hospitalization (P<0.05). The area under the curve predicted by the combination of miR-483-5p and miR-487b on 7d hospitalization was 0.964, which was higher than those predicted by miR-483-5p and miR-487b alone (z=2.612, 3.141,P<0.05). Conclusion: The expression of miR-483-5p is up-regulated and miR-487b is down-regulated in serum of ALI patients induced by sepsis, which is related to excessive inflammatory response, aggravation of the disease, and poor prognosis.

Key words： Sepsis Acute lung injury Inflammatory factors Prognosis Micro ribonucleic acid MiR-483-5p MiR-487b

基金资助:湖北省卫生和计划生育委员会联合基金项目,(编号:WJ2018H00155)

通讯作者: 雷育军

引用本文:

戴梅, 王丽, 沙丹, 张薇, 王昕, 雷育军. 血清miR-483-5p miR-487b表达与脓毒症所致急性肺损伤患者炎性因子病情和预后的关系研究[J]. 河北医学, 2022, 28(9): 1484-1490.
DAI Mei, WANG Li, YU Feng, et al. Relationship between Serum miR-483-5p and miR-487b Expression and Inflammatory Factors Disease and Prognosis in Patients with Acute Lung Injury Induced by Sepsis. HeBei Med, 2022, 28(9): 1484-1490.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2022.09.015 或 http://www.hbyxzzs.cn/CN/Y2022/V28/I9/1484

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