摘要
目的探讨消化性溃疡合并幽门螺杆菌(Hp)感染患者血清微小RNA(miR)-155和miR-135b-5p表达水平及其临床意义。方法采用前瞻性研究的方法,连续选取济宁医学院附属医院2021年7月至2023年2月消化性溃疡患者263例。其中,经14C呼气试验确定为Hp感染146例(Hp感染组),未合并Hp感染117例(非Hp感染组);免疫印迹法确定Ⅰ型Hp感染110例,Ⅱ型Hp感染36例。采用实时荧光定量聚合酶链反应法检测血清miR-155和miR-135b-5p表达水平,放射免疫法检测血清胃泌素水平,酶联免疫吸附法检测血清胃蛋白酶原(PG)Ⅰ和PGⅡ水平;记录患者基本临床资料。采用多因素Logistic回归分析影响消化性溃疡患者发生Hp感染的独立危险因素;采用受试者工作特征(ROC)曲线分析血清miR-155和miR-135b-5p对消化性溃疡患者发生Hp感染的诊断价值。结果Hp感染组胃泌素、PGⅠ、PGⅡ、溃疡出血率和复发比例明显高于非Hp感染组[(108.47±15.35)ng/L比(79.63±10.58)ng/L、(295.41±37.26)pg/L比(236.75±29.17)pg/L、(44.08±8.52)pg/L比(39.29±6.74)pg/L、25.34%(37/146)比15.38%(18/117)和21.92%(32/146)比11.97%(14/117)],差异有统计学意义(P<0.01或<0.05)。Hp感染组血清miR-155和miR-135b-5p明显高于非Hp感染组(1.94±0.63比0.95±0.29和1.86±0.57比1.03±0.31),差异有统计学意义(P<0.01)。Ⅰ型Hp感染患者血清miR-155和miR-135b-5p明显高于Ⅱ型Hp感染患者(2.05±0.66比1.60±0.54和1.97±0.61比1.52±0.45),差异有统计学意义(P<0.01)。多因素Logistic回归分析结果显示,血清miR-155、miR-135b-5p、胃泌素、PGⅠ是影响消化性溃疡患者发生Hp感染的独立危险因素(OR=1.443、1.436、1.452和1.438,95%CI 1.165~1.787、1.146~1.799、1.187~1.777和1.150~1.798,P<0.01)。ROC曲线分析结果显示,血清miR-155和miR-135b-5p联合诊断消化性溃疡患者发生Hp感染的曲线下面积明显大于血清miR-155和miR-135b-5p单独诊断(0.907比0.839和0.836,Z=2.57和2.81,P=0.010和0.005)。结论消化�
Objective To investigate the expression levels and clinical significance of serum microRNA(miR)-155 and miR-135b-5p in patients with peptic ulcer complicated with Helicobacter pylori(Hp)infection.Methods A prospective study was conducted,and 263 patients with peptic ulcer were selected consecutively from July 2021 to February 2023 at the Affiliated Hospital of Jining Medical College.Among them,146 cases were confirmed as Hp infection(Hp infection group)and 117 cases were not complicated with Hp infection(non Hp infection group)by 14C breath test;typeⅠHp infection was in 110 cases,and typeⅡHp infection was in 36 cases by immunoblotting method.The serum expression levels of miR-155 and miR-135b-5p were detected by real-time fluorescence quantitative polymerase chain reaction,serum gastrin level was detected by radioimmunoassay method,and the serum pepsinogen(PG)Ⅰand PGⅡwere detected by enzyme linked immunosorbent assay.The clinical data were recorded.Multivariate Logistic regression analysis was used to analyze the independent risk factors of Hp infection in patients with peptic ulcer;receiver operating characteristic(ROC)curve was used to analyze the efficacy of serum miR-155 and miR-135b-5p in diagnosis the Hp infection in patients with peptic ulcer.Results The gastrin,PGⅠ,PGⅡ,ulcer bleeding rate and recurrence rate in Hp infection group were significantly higher than those in non Hp infection group:(108.47±15.35)ng/L vs.(79.63±10.58)ng/L,(295.41±37.26)pg/L vs.(236.75±29.17)pg/L,(44.08±8.52)pg/L vs.(39.29±6.74)pg/L,25.34%(37/146)vs.15.38%(18/117)and 21.92%(32/146)vs.11.97%(14/117),and there were statistical differences(P<0.01 or<0.05).The serum miR-155 and miR-135b-5p in Hp infection group were significantly higher than those in non Hp infection group(1.94±0.63 vs.0.95±0.29 and 1.86±0.57 vs.1.03±0.31),and there were statistical differences(P<0.01).The serum miR-155 and miR-135b-5p in patients with typeⅠHp infection were significantly higher than those in patients with typeⅡHp infection(2
作者
艾宽宽
胡瑞瑞
薛原
王岩
Ai Kuankuan;Hu Ruirui;Xue Yuan;Wang Yan(Department of Gastroenterology,Affiliated Hospital of Jining Medical College,Jining 272000,China)
出处
《中国医师进修杂志》
2024年第3期237-241,共5页
Chinese Journal of Postgraduates of Medicine
基金
山东省卫生和计划生育委员会科研课题(2016WS0172)。
