miR-150時序變化在膿毒癥診斷和預(yù)后中的價值研究
發(fā)布時間：2018-07-28 15:37
【摘要】：目的:探討mi R-150的時序變化在早期診斷膿毒癥及判斷病情嚴(yán)重程度和預(yù)后中的價值。方法:選取新疆石河子大學(xué)醫(yī)學(xué)院第三附屬醫(yī)院2016年2月至2017年1月54例膿毒癥患者為病例組,并分為膿毒癥組和感染性休克組,同時選取30名同期健康者為對照組。病例組分別在治療前(D0)和治療后第1天(D1)、第2天(D2)、第3天(D3)、第7天(D7)抽取靜脈血標(biāo)本,采用熒光定量PCR方法檢測血漿中mi R-150,化學(xué)發(fā)光法測定血清中降鈣素原(PCT)、IL-6,免疫比濁法測定C反應(yīng)蛋白(CRP)表達水平,計算以上各時間點序貫器官衰竭估計評分(SOFA)、急性生理與慢性健康評分(APACHEII);28天隨訪預(yù)后;對照組在入組時采集血液標(biāo)本,同方法檢測上述指標(biāo)。采用t檢驗或Mann-Whitney U檢驗比較兩組間各時間點的mi R-150的表達水平,單因素方差分析法比較兩組內(nèi)以上各時間點的mi R-150的變化情況,采用Pearson相關(guān)系數(shù)分析各指標(biāo)與SOFA評分、APCACHE II評分的關(guān)系,采用受試者工作特征曲線(ROC)分析mi R-150對膿毒癥患者的早期診斷和預(yù)后的預(yù)測價值。結(jié)果:(1)病例組與對照組比較,各時間點mi R-150表達水平升高(P0.01);mi R-150表達水平由D0時明顯升高,于D2達到最高峰,隨后下降,D7時低于D0,但無統(tǒng)計學(xué)意義(P0.05);(2)mi R-150診斷膿毒癥的ROC曲線顯示,mi R-150的曲線下面積(AUC)為0.83,cut-off值為2.88,敏感性、特異性分別為69%,93%,其AUC低于PCT、CRP(P0.05),但高于IL-6(P0.05),IL-6的AUC最小;(3)感染性休克組mi R-150表達水平在D0、D3均明顯高于膿毒癥組(P0.05),D1、D2、D7時高于膿毒癥組,但兩組間差異無統(tǒng)計學(xué)意義(P0.05);D0時感染性休克組SOFA評分、APACHEII評分均高于膿毒癥組(P0.05);經(jīng)Pearson相關(guān)系數(shù)分析顯示,病例組D0時mi R-150與SOFA評分、APACHEII評分均呈正相關(guān);(4)存活組D0時mi R-150水平明顯低于死亡組,差異具有統(tǒng)計學(xué)意義(P0.05);同時SOFA評分、APACHEII評分明顯低于死亡組,差異具有統(tǒng)計學(xué)意義(P0.05);mi R-150預(yù)測膿毒癥預(yù)后的ROC曲線顯示,mi R-150的曲線下面積(AUC)為0.77,其低于PCT(P0.05),高于CRP、IL-6(P0.05),IL-6的AUC最小。結(jié)論:血漿mi R-150在膿毒癥病程中表達穩(wěn)定、表達上調(diào),可能是潛在的生物標(biāo)記物;mi R-150與膿毒癥病情嚴(yán)重程度相關(guān),病情越嚴(yán)重表達水平越高;mi R-150在膿毒癥早期診斷和預(yù)后預(yù)測中有潛在的價值。
[Abstract]:Objective: to investigate the value of the timing changes of miR-150 in the early diagnosis of sepsis and in judging the severity and prognosis of sepsis. Methods: 54 patients with sepsis from February 2016 to January 2017 in the third affiliated Hospital of Medical College of Shihezi University were divided into sepsis group and septic shock group and 30 healthy persons were selected as control group. Venous blood samples were collected before and after treatment (D1), 2nd (D2), 3rd (D3), 7th (D7) in the case group, respectively, before treatment (D0) and on the first day (D1), the second day (D2), the third day (D3), and the 7th day (D7), respectively. The plasma miR-150 was detected by fluorescence quantitative PCR, the serum calcitonin proto (PCT) IL-6 was detected by chemiluminescence assay, and the expression of C-reactive protein (CRP) was detected by immunoturbidimetric method. The (SOFA), acute physiological and chronic health score (APACHEII) was followed up for 28 days, and the blood samples were collected at the time of entry of the control group, and the above indexes were detected by the same method. T test or Mann-Whitney U test were used to compare the expression level of miR-150 at each time point between the two groups, and single-factor variance analysis was used to compare the changes of miR-150 between the two groups at each time point above. The correlation coefficient of Pearson was used to analyze the relationship between each index and the SOFA score and Apache II score. The (ROC) analysis of the operating characteristic curve was used to analyze the predictive value of miR-150 in the early diagnosis and prognosis of sepsis patients. Results: (1) compared with the control group, the expression level of miR-150 increased significantly (P0.01) at different time points (P0.01) and reached its peak at D2. However, the ROC curve of miR-150 for the diagnosis of sepsis had no statistical significance (P0.05); (2). The area under the curve of MMI R-150 was 0.83 cut-off value (2.88), which showed that the area under the curve was 0.83 and the sensitivity was 2.88. The specificity was 69 / 93.The AUC was lower than that of IL-6 (P0.05), but higher than that of IL-6 (P0.05) IL-6. (3) the expression level of miR-150 in septic shock group was significantly higher than that in septic group (P0.05), and was higher than that in septic group (P0.05). However, there was no significant difference between the two groups (P0.05). The SOFA score of septic shock group was higher than that of septic group (P0.05). There was a positive correlation between miR-150 and SOFA score and Apache II score at D0. (4) the level of miR-150 in survival group was significantly lower than that in death group (P0.05), and the SOFA score was significantly lower than that in death group. The ROC curve for predicting the prognosis of sepsis showed that the area under the curve of MMI R-150 was 0.77, which was lower than that of PCT (P0.05), and higher than that of AUC with IL-6 (P0.05). Conclusion: the expression of plasma miR-150 is stable and up-regulated in the course of sepsis, which may be a potential biomarker associated with the severity of sepsis. The more severe the disease, the higher the expression level of mi-R-150 has potential value in early diagnosis and prognosis prediction of sepsis.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R459.7
本文編號：2150741
[Abstract]:Objective: to investigate the value of the timing changes of miR-150 in the early diagnosis of sepsis and in judging the severity and prognosis of sepsis. Methods: 54 patients with sepsis from February 2016 to January 2017 in the third affiliated Hospital of Medical College of Shihezi University were divided into sepsis group and septic shock group and 30 healthy persons were selected as control group. Venous blood samples were collected before and after treatment (D1), 2nd (D2), 3rd (D3), 7th (D7) in the case group, respectively, before treatment (D0) and on the first day (D1), the second day (D2), the third day (D3), and the 7th day (D7), respectively. The plasma miR-150 was detected by fluorescence quantitative PCR, the serum calcitonin proto (PCT) IL-6 was detected by chemiluminescence assay, and the expression of C-reactive protein (CRP) was detected by immunoturbidimetric method. The (SOFA), acute physiological and chronic health score (APACHEII) was followed up for 28 days, and the blood samples were collected at the time of entry of the control group, and the above indexes were detected by the same method. T test or Mann-Whitney U test were used to compare the expression level of miR-150 at each time point between the two groups, and single-factor variance analysis was used to compare the changes of miR-150 between the two groups at each time point above. The correlation coefficient of Pearson was used to analyze the relationship between each index and the SOFA score and Apache II score. The (ROC) analysis of the operating characteristic curve was used to analyze the predictive value of miR-150 in the early diagnosis and prognosis of sepsis patients. Results: (1) compared with the control group, the expression level of miR-150 increased significantly (P0.01) at different time points (P0.01) and reached its peak at D2. However, the ROC curve of miR-150 for the diagnosis of sepsis had no statistical significance (P0.05); (2). The area under the curve of MMI R-150 was 0.83 cut-off value (2.88), which showed that the area under the curve was 0.83 and the sensitivity was 2.88. The specificity was 69 / 93.The AUC was lower than that of IL-6 (P0.05), but higher than that of IL-6 (P0.05) IL-6. (3) the expression level of miR-150 in septic shock group was significantly higher than that in septic group (P0.05), and was higher than that in septic group (P0.05). However, there was no significant difference between the two groups (P0.05). The SOFA score of septic shock group was higher than that of septic group (P0.05). There was a positive correlation between miR-150 and SOFA score and Apache II score at D0. (4) the level of miR-150 in survival group was significantly lower than that in death group (P0.05), and the SOFA score was significantly lower than that in death group. The ROC curve for predicting the prognosis of sepsis showed that the area under the curve of MMI R-150 was 0.77, which was lower than that of PCT (P0.05), and higher than that of AUC with IL-6 (P0.05). Conclusion: the expression of plasma miR-150 is stable and up-regulated in the course of sepsis, which may be a potential biomarker associated with the severity of sepsis. The more severe the disease, the higher the expression level of mi-R-150 has potential value in early diagnosis and prognosis prediction of sepsis.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R459.7
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