摘要
目的探讨血清微小RNA-146a(miR-146a)、脂蛋白相关性磷脂酶A2(Lp-PLA2)与脓毒症急性肾损伤(AKI)患者肾功能的相关性。方法选取2020年2月—2022年2月本院感染性疾病科住院的88例脓毒症患者进行回顾性分析,根据入院24 h内是否发生AKI分组(包括入院时已发生AKI的患者),将40例发生AKI的患者设为观察组1,48例未发生AKI的患者设为观察组2,另选取同期本院体检中心的45例健康体检者设为对照组。检测、比较3组入院24 h内/体检时血清miR-146a、Lp-PLA2、肾功能[胱抑素C(Cys-C),血肌酐(Scr)]指标。根据脓毒症AKI疾病严重程度,将观察组1患者分为休克组(7例)、重度组(20例)、轻度组(13例),比较脓毒症AKI患者中不同疾病严重程度、不同AKI分期组血清miR-146a、Lp-PLA2、肾功能指标,Pearson分析miR-146a、Lp-PLA2与肾功能指标的相关性,绘制受试者工作曲线(ROC),计算曲线下面积(AUC),分析miR-146a、Lp-PLA2、肾功能对脓毒症发生AKI的预测效能。结果观察组1入院24 h内血清miR-146a、Lp-PLA2、Cys-C、Scr均高于观察组2及对照组(P<0.05)。脓毒症休克组血清miR-146a、Lp-PLA2、Cys-C、Scr均高于重度组及轻度组(P<0.05)。AKIⅢ期组血清miR-146a、Lp-PLA2、Cys-C、Scr均高于Ⅱ期组及Ⅰ期组(P<0.05)。入院24 h内血清miR-146a、Lp-PLA2与Cys-C、Scr均呈正相关性(P<0.05)(r=0.421、0.417、0.398、0.387)。血清miR-146a、Lp-PLA2、Cys-C、Scr联合检测预测脓毒症发生AKI的AUC为0.798,(95%CI:0.716~0.947),灵敏度是93.13%,特异度是91.84%,联合检测预测脓毒症发生AKI的灵敏度及特异度均高于单独检测(P<0.05)。结论脓毒症AKI患者血清miR-146a、Lp-PLA2呈高表达,与Cys-C、Scr呈相关性,血清miR-146a、Lp-PLA2联合Cys-C、Scr检测可提高对AKI的预测灵敏度及特异度,在脓毒症患者AKI诊断中具有一定的参考价值。
Objective To analyze the correlation between serum micrornA-146A(miR-146a),lipoprotein-associated phospholipase A2(Lp-PLA2)and renal function in patients with acute kidney injury(AKI)caused by sepsis.Methods A retrospective study was conducted on 88 patients with sepsis who were hospitalized in the Department of Infectious Diseases of our hospital from February 2020 to February 2022.According to whether AKI occurred within 24 hours of admission(including those who had AKI at the time of admission),40 patients with AKI were set as observation group and 48 patients without AKI were set as observation group 2.Another 45 healthy physical examination subjects received by our physical examination center during the same period were selected as the control group.Serum miR-146a,Lp-PLA2 and renal function indexes of the three groups were detected and compared within 24h after admission/during physical examination.Patients were divided into shock group(7 cases),severe group(20 cases)and mild group(13 cases)according to the severity of septic AKI disease.Serum miR-146a,Lp-PLA2 and renal function indexes in different disease severity and AKI stage groups in patients with sepsis were compared.Pearson analyzed the correlation between miR-146a,Lp-PLA2 and renal function indexes,plotted receiver operating curve(ROC),and calculated the area under the curve(AUC).The predictive effects of miR-146a,Lp-PLA2 and renal function on AKI in sepsis were analyzed.Results Serum miR-146a,Lp-PLA2,cystatin C(Cys-C)and serum creatinine(Scr)in observation group 1 were higher than those in observation group 2 and control group within 24h after admission(P<0.05).Serum miR-146a,Lp-PLA2,Cys-C and Scr in septic shock group were higher than those in severe and mild groups(P<0.05).The serum miR-146a,Lp-PLA2,Cys-C and Scr in AKIIII group were higher than those in II and I groups(P<0.05).Serum miR-146a and Lp-PLA2 were positively correlated with Cys-C and Scr within 24h after admission(P<0.05)(r=0.421,0.417,0.398,0.387).The AUC of serum miR-146a,Lp-PLA2,Cy
作者
李文婷
王荣
吴阳
张燕
蒋海燕
宗春燕
LI Wenting;WANG Rong;WU Yang;ZHANG Yan;JIANG Haiyan;ZONG Chunyan(Nantong First People's Hospital,Nantong 226001,Jiangsu,China)
出处
《西部医学》
2024年第7期1031-1036,共6页
Medical Journal of West China
基金
国家自然科学基金青年科学基金项目(8180080956)
南通市卫生健康委科研课题(指令性)项目(MS2022022)。
