摘要
目的分析微RNA(miR)-155-5p、miR-16、miR-129-5p对脓毒性休克患儿连续肾脏替代疗法(CRRT)疗效的预测价值。方法回顾性选取2021年1月至2022年1月山西省儿童医院收治的179例重症脓毒症患儿,其中89例脓毒性休克患儿为A组,90例脓毒症非休克患儿为B组,另选择同期参加体检的健康儿童80例为C组。比较各组miR-155-5p、miR-16、miR-129-5p表达水平;A组患儿根据CRRT疗效分为有效组、无效组,比较两组miR-155-5p、miR-16、miR-129-5p表达的差异及对CRRT疗效的预测价值。结果A组miR-155-5p表达量高于B、C组(2.56±0.98比1.41±0.35、0.53±0.11),miR-16、miR-129-5p表达量低于B、C组(1.00±0.27比2.23±0.98和3.38±1.01、0.65±0.17比1.39±0.22和2.25±0.76),差异有统计学意义(P<0.05);B组miR-155-5p表达量高于C组,miR-16、miR-129-5p表达量低于C组,差异有统计学意义(P<0.05)。Logistic回归分析发现,序贯器官衰竭量表评分、白细胞计数、C反应蛋白、降钙素原、白细胞介素6(IL-6)、肿瘤坏死因子-α、N末端B型利钠肽前体水平和miR-155-5p、miR-16、miR-129-5p表达水平为影响脓毒性休克患儿CRRT疗效的独立危险因素(P<0.05)。Pearson相关分析结果表明,miR-155-5p与miR-16、miR-129-5p呈负相关(r=-0.411、-0.369,P<0.05);miR-16与miR-129-5p呈正相关(r=0.444,P<0.05)。受试者工作特征曲线分析结果表明,miR-155-5p、miR-16、miR-129-5p联合检测对脓毒性休克患儿CRRT治疗疗效的预测价值高于单项指标(P<0.05)。miR-155-5p高表达、miR-16及miR-129-5p低表达的脓毒性休克患儿病死率较高(P<0.05)。结论miR-155-5p、miR-16、miR-129-5p在脓毒性休克患儿中表达异常,且与CRRT疗效有关,可用于CRRT疗效的早期预测。
Objective To analyze the predictive value of miR-155-5p,miR-16 and miR-129-5p on the efficacy of continuous renal replacement therapy(CRRT)in children with septic shock.Methods A total of 179 children with severe sepsis admitted to Shanxi Provincial Children′s Hospital from January 2021 to January 2022 were selected,89 children with septic shock were selected as group A,90 children with non-septic shock were selected as group B,and 80 healthy children were selected as group C.The expressions of miR-155-5p,miR-16 and miR-129-5p were measured and compared.The patients in the group A were divided into the effective group and the ineffective group according to the curative effect of CRRT treatment.The expressions of miR-155-5p,miR-16 and miR-129-5p in the two groups were compared,and its predictive value for the efficacy of CRRT treatment was analyzed.Results Compared with group C and group B,the expressions of miR-155-5p in group A was higher:2.56±0.98 vs.1.41±0.35,0.53±0.11;and the expressions of miR-16 and miR-129-5p were lower:1.00±0.27 vs.2.23±0.98,3.38±1.01;0.65±0.17 vs.1.39±0.22,2.25±0.76,there were statistical differences(P<0.05).The results of Logistic regression analysis showed that the sequential organ failure assessment(SOFA)scores,white blood cell count,C reactive protein,procalcitonin,interleukin-6,tumor necrosis factor-alpha,N-terminal B-type natriuretic peptide precursor and the expressions of miR-155-5p,miR-16,miR-129-5p were independent risk factors for the efficacy of CRRT treatment in the children with septic shock.The results of Pearson correlation analysis showed that miR-155-5p was negative correlation with miR-16 and miR-129-5p(r=-0.411,-0.369,P<0.05);and miR-16 was positive correlation with miR-129-5p(r=0.444,P<0.05).The results of receiver operating characteristic curve showed that the combination of the three items had a higher predictive value for the efficacy of CRRT in children with septic shock(P<0.05).Children with high expression of miR-155-5p and low expression of miR-16 a
作者
张荣
张芳
翟颖如
王朝海
Zhang Rong;Zhang Fang;Zhai Yingru;Wang Chaohai(Department of Pediatric Critical Care Medicine,Shanxi Provincial Children′s Hospital,Taiyuan 030000,China)
出处
《中国医师进修杂志》
2023年第10期920-924,共5页
Chinese Journal of Postgraduates of Medicine
基金
山西省儿童医院院级课题(2021050)。
