摘要
目的 探讨血浆miR-205、miR-21在慢性阻塞性肺疾病急性加重期(AECOPD)患者中的表达水平及临床意义。方法 选取2022年1—12月收治的COPD 140例,另选取同期体检的健康人群70例作为健康组。根据COPD是否进入急性加重期将患者分为急性加重组63例与稳定组77例。采用荧光定量PCR法检测3组血浆miR-205、miR-21水平,采用受试者工作特征曲线评估血浆miR-205、miR-21对AECOPD发生的预测价值,采用多因素Logistic逐步回归分析探讨AECOPD预后的影响因素。结果 稳定组和急性加重组COPD患者血浆miR-205、miR-21水平均高于健康组,且急性加重组高于稳定组(P<0.05)。血浆miR-205、miR-21联合预测AECOPD发生的曲线下面积大于二者单独预测。死亡组AECOPD患者血浆miR-205、miR-21水平高于生存组(P<0.05)。血浆miR-205、miR-21高表达及急性生理与慢性健康状况Ⅱ系统评分≥2分是AECOPD患者入院后28 d死亡的危险因素(P<0.01)。结论 AECOPD患者血浆miR-205、miR-21表达水平明显升高,可作为早期诊断和预后的生物学指标,且二者联合预测AECOPD患者发生的效能更高。
Objective To investigate the expression levels and clinical significance of plasma miR-205 and miR-21 in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 140 COPD patients admitted from January to December 2022 were selected,and 70 healthy people who underwent physical examination during the same period were selected as the healthy group.According to whether COPD entered the acute exacerbation stage,the patients were divided into acute exacerbation group(n=63) and stable group(n=77).The plasma levels of miR-205 and miR-21 in the three groups were detected by fluorescence quantitative PCR.The predictive value of plasma miR-205 and miR-21 for the occurrence of AECOPD was evaluated by receiver operating characteristic(ROC) curve.The influencing factors of the occurrence of AECOPD were investigated by multivariate Logistic regression analysis.Results Plasma miR-205 and miR-21 levels in COPD patients in stable group and acute exacerbation group were higher than those in healthy group,and the levels in acute exacerbation group were higher than those in stable group(P<0.05).The area under the ROC curve(AUC) of plasma miR-205 and miR-21 in combination for prediction was higher than that for prediction alone.Plasma miR-205 and miR-21 levels of AECOPD patients in death group were higher than those in survival group(P<0.05).Plasma miR-205 and plasma miR-21 high expression and acute physiological and chronic health status II system scores ≥ 2 were risk factors for 28-day mortality after admission in AECOPD patients(P<0.01).Conclusion The expression levels of miR-205 and miR-21 in plasma of AECOPD patients were significantly increased,which could be used as biological indicators for early diagnosis and prognosis,and the combination of the two could predict the prognosis of AECOPD patients more effectively.
作者
董慧文
苑萌
张志斌
DONG Huiwen;YUAN Meng;ZHANG Zhibin(Department of Emergency,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)
出处
《临床误诊误治》
CAS
2024年第3期78-82,共5页
Clinical Misdiagnosis & Mistherapy
基金
河北省2023年度医学科学研究课题计划项目(20231452)。
