摘要
目的探究血清微小RNA-98(miR-98)水平与脓毒症患者自杀相关因子/配体(Fas/FasL)系统、疾病严重程度和短期预后的关系。方法选取自2018年9月至2021年1月急诊重症监护室治疗的63例脓毒症、30例脓毒性休克住院患者为研究对象。另外选取30例健康志愿者作为健康组。采集各组血液标本,利用高通量测序技术检测血清中miRNAs差异表达;采用实时荧光定量聚合酶链式反应法检测血清miR-98相对表达量。酶联免疫吸附法检测血清sFas及sFasL浓度。结果与健康组相比,脓毒症组有35个miRNA显著上调,38个miRNA显著下调(P<0.05)。其中,miR-98表达降低2.3倍,故而作为候选基因。经实时荧光定量聚合酶链式反应扩增,脓毒症组患者血清miR-98相对表达量低于健康组(P<0.05),且脓毒性休克患者降低更明显(P<0.05)。经相关性分析,血清miR-98相对表达量与血清sFas、sFasL水平、序贯器官功能衰竭评估评分、急性生理与慢性健康评分Ⅱ评分均呈负相关性。20例患者30 d内死亡,病死组患者血清miR-98相对表达量低于存活组,同时,血清sFas、sFasL水平显著高于存活组(P<0.05)。结论血清miR-98检测有助于准确地反映脓毒症患者的临床特征,并有望成为评估脓毒症严重程度和预后的潜在生物标志物,其作用机制之一与调控Fas/FasL细胞凋亡通路有关。
Objective To investigate the correlation between serum miR-98 level and soluble factor associated suicide and its associated ligand(Fas/FasL)system,severity of disease and short-term prognosis in sepsis.Methods Blood samples were collected from 63 septic patients and 30 septic shock patients in Emergency Intensive Care Unit from September 2018 to March 2021.And 30 healthy volunteers were selected as healthy group.The differential expressions of miRNAs in the serum samples were detected byhigh-throughput sequencing technology.The quantitative polymerase chain reaction real-time polymerase chain reaction(qRT-PCR)was used to amplify the sample size to verify the results and to screen the highly-expressed miR-98 in septic patients.ELISA assay was used to detect the levels of soluble factor associated suicide(sFas)and soluble Fas ligand(sFasL).Results High-throughput sequencing results showed that,compared with those in healthy individuals,35 miRNA molecules were up-regulated,and 38 molecules were down-regulated in the serum samples of septicpatients(P<0.05),including miR-98 down-regulated with 2.3 fold changes as the candidate miRNA.qRT-PCR also showed the relative expression of serum miR-98 in sepsis patients was lower than that in control group,especially insseptic shock patients(P<0.05).Furthermore,miR-98 was negatively correlated with serum sFas,sFasL levels,sequential organ failure assessment sore and acute physiology and chronic health evaluationⅡscore(P<0.05).Twenty patients died within 30 days.The relative expression of serum miR-98 of the dead group was lower than that of the survival group,and the level of serum sFas and sFasL were also significantly higher than that of the survival group(P<0.05).Conclusion The detection of serum miR-98 can accurately reflect the clinical features of septic patients,and may be a potential biomarker for evaluating the severity and prognosis of sepsis.One of its mechanisms would be related to the regulation of Fas/FasL apoptosis pathway.
作者
李英
邓超
计超
LI Ying;DENG Chao;JI Chao(Department of Critical Medicine,Haikou People′s Hospital,Haikou 570208,China)
出处
《创伤与急危重病医学》
2022年第2期105-109,114,共6页
Trauma and Critical Care Medicine
基金
海南省重点研发计划项目任务书(ZDYFXGFY2020007)。
