摘要
目的探讨血清长链非编码RNA-肺腺癌转移相关转录本1(LncRNA-MALAT1)、血管生成素-2(Ang-2)与重症急性胰腺炎(SAP)患者并发急性胃肠损伤(AGI)的相关性。方法选取2021年1月—2023年1月苏州大学附属苏州市第九人民医院重症医学科收治的轻症急性胰腺炎(AP)患者78例为轻症AP组、中度AP患者78例为中度AP组、SAP患者145例为SAP组,根据是否并发AGI将SAP患者分为AGI亚组83例和非AGI亚组62例。采用实时荧光定量PCR检测血清LncRNA-MALAT1水平,酶联免疫吸附法检测血清Ang-2水平;多因素Logistic回归分析SAP患者并发AGI的影响因素;受试者工作特征(ROC)曲线评价血清LncRNA-MALAT1、Ang-2水平对SAP患者并发AGI的预测价值。结果轻症AP组、中度AP组、SAP组血清LncRNA-MALAT1、Ang-2水平依次升高(F/P=659.197/<0.001、682.682/<0.001);145例SAP患者AGI发生率为57.24%(83/145),AGI亚组SAP患者多器官功能障碍综合征(MODS)比例、急性生理和慢性健康评估Ⅱ(APACHEⅡ)评分、ICU停留时间及血清D-乳酸、LncRNA-MALAT1、Ang-2水平高于非AGI亚组(χ^(2)/t/P=19.273/<0.001、5.052/<0.001、5.308/<0.001、4.085/<0.001、6.864/<0.001、6.824/<0.001);多因素Logistic回归结果示,MODS、APACHEⅡ评分高、D-乳酸高、LncRNA-MALAT1高、Ang-2高为SAP患者并发AGI的独立危险因素[OR(95%CI)=4.496(1.335~15.138)、1.331(1.142~1.551)、1.070(1.020~1.123)、1.101(1.055~1.148)、1.571(1.239~1.994)];血清LncRNA-MALAT1、Ang-2水平及二者联合预测SAP患者并发AGI的AUC分别为0.790、0.785、0.895,二者联合的AUC大于血清LncRNA-MALAT1、Ang-2水平单独预测(Z/P=3.143/0.002、3.650/<0.001)。结论血清LncRNA-MALAT1、Ang-2水平升高与SAP患者并发AGI独立相关,血清LncRNA-MALAT1联合Ang-2水平预测SAP患者并发AGI的价值较高。
Objective To investigate the correlation between serum long non-coding RNA-metastasis-associated lung adenocarcinoma transcript 1(LncRNA-MALAT1),angiopoietin-2(Ang-2)and acute gastrointestinal injuries(AGI)in patients with severe acute pancreatitis(SAP)with complications.Methods Seventy-eight patients with mild AP admitted to the Department of Intensive Care Medicine of the Suzhou Ninth People's Hospital Affiliated to Suzhou University were selected as the mild AP group,78 patients with moderate SAP were selected as the moderate SAP group,and 145 patients with SAP were selected as the SAP group,and the patients with SAP were divided into the AGI subgroup of 83 and the non-AGI subgroup of 62 based on the presence or absence of concomitant AGI.Real-time fluorescence quantitative PCR was used to detect serum LncRNA-MALAT1 levels,and enzyme-linked immunosorbent assay was used to detect serum Ang-2 levels;multifactorial Logistic regression was used to analyze the influencing factors of SAP patients with concurrent AGI;and receiver operating characteristic(ROC)curves were used to evaluate the predictive value of serum LncRNA-MALAT1 and Ang-2 levels on SAP patients'predictive value of concurrent AGI.Results Serum LncRNA-MALAT1 and Ang-2 levels were sequentially increased in the mild AP,moderate SAP,and SAP groups(F/P=659.197/<0.001,682.682/<0.001);The complication rate of AGI in 145 SAP patients was 57.24%(83/145),and the proportion of multiple organ dysfunction syndrome(MODS),acute physiology and chronic health evaluationⅡ(APACHEⅡ)scores,duration of ICU stay,and serum D-lactate,LncRNA-MALAT1,and Ang-2 levels were higher in the SAP patients in the AGI subgroup than in the non-AGI subgroup(χ^(2)/t/P=19.273/<0.001,5.052/<0.001,5.308/<0.001,4.085/<0.001,6.864/<0.001,6.824/<0.001);The results of multifactorial Logistic regression showed that high MODS,high APACHE II score,high D-lactate,high LncRNA-MALAT1,and high Ang-2 were the independent risk factors for the complication of AGI in patients with SAP[OR(95%CI)=4.496(1
作者
马家驹
邹晗
晏倩
李玉卓
浦秦华
Ma Jiaju;Zou Han;Yan Qian;Li Yuzhuo;Pu Qinhua(Department of Intensive Care Medicine,Suzhou Ninth People's Hospital Affiliated to Suzhou University,Jiangsu Province,Suzhou 215200,China)
出处
《疑难病杂志》
CAS
2024年第10期1221-1226,共6页
Chinese Journal of Difficult and Complicated Cases
基金
江苏省医学科研项目(H2020241)。
