本文關(guān)鍵詞： 膿毒癥 miR-a miR-a-p 急性腎損傷 生存率　出處：《南方醫(yī)科大學(xué)學(xué)報(bào)》2017年05期 　論文類(lèi)型：期刊論文

【摘要】：目的探討miR-29a和miR-10a-5p對(duì)評(píng)估膿毒癥伴有急性腎損傷(AKI)患者28 d死亡率的預(yù)測(cè)價(jià)值。方法收集我院124例急性腎損傷患者(AKI)血清樣本,分為觀察組(74例膿毒癥所致AKI)和對(duì)照組(膿毒癥無(wú)AKI)41例,記錄患者一般情況,并用RT-PCR檢測(cè)其中miR-29a和miR-10a-5p的表達(dá)情況,隨訪(fǎng)28 d,記錄患者生存情況,采用Pearson相關(guān)分析檢驗(yàn)miR-29a和miR-10a-5p與觀察組患者血清肌酐(Scr)、胱抑素C(Cys-C)和腎損傷分子1(KIM-1)的相關(guān)性;多因素Logistic回歸分析miR-29a、miR-10a-5p、Scr、Cys-C、KIM-1以及其他危險(xiǎn)因素與膿毒癥患者28 d死亡率的相關(guān)性。ROC曲線(xiàn)分析比較miR-29a和miR-10a-5p與Cys-C和Scr在膿毒癥患者預(yù)后評(píng)估中的價(jià)值,最后進(jìn)一步用統(tǒng)計(jì)學(xué)方法分析miR-29a和miR-10a-5p聯(lián)合與Scr及Cys-C聯(lián)合對(duì)膿毒癥患者預(yù)后評(píng)估的價(jià)值。結(jié)果隨訪(fǎng)28 d后:(1)74例AKI患者中21例死亡,占整體人數(shù)的35.53%;(2)相比于生存組,死亡組患者血清Scr及Cys-C表達(dá)上升(P0.05),死亡組患者血清中miR-29a和miR-10a-5p表達(dá)升高,有統(tǒng)計(jì)學(xué)意義(P0.05);(3)Pearson相關(guān)分析結(jié)果顯示miR-29a和miR-10a-5p分別與Scr、Cys-C及KIM-1表達(dá)呈正相關(guān);(4)多因素回歸結(jié)果顯示,miR-29a和miR-10a-5p均為膿毒癥患者死亡的獨(dú)立危險(xiǎn)因素;(5)ROC曲線(xiàn)分析結(jié)果顯示miR-29a和miR-10a-5p曲線(xiàn)下面積(au Ro C)分別為0.82(95%CI,0.71-0.89)及0.75(95%CI,0.64-0.85),Cys-C、Scr和KIM-1曲線(xiàn)下面積分別為0.72(95%CI,0.66-0.86)、0.71(95%CI,0.63-0.84)及0.81(95%CI,0.72-0.81)。miR-29a及miR-10a-5p二者聯(lián)合檢測(cè)的au ROC值優(yōu)于單一檢測(cè)miR-29a、miR-10a-5p、Cys-C、Scr和KIM-1(P0.05)。結(jié)論 miR-29a和miR-10a-5p在評(píng)估膿毒癥患者死亡率時(shí)具有良好的預(yù)測(cè)價(jià)值。
[Abstract]:Objective to investigate the value of miR-29a and miR-10a-5p in the evaluation of sepsis with acute renal injury. Methods Serum samples of 124 patients with acute renal injury were collected. The patients were divided into observation group (n = 74) and control group (n = 74) and control group (n = 74). The expression of miR-29a and miR-10a-5p was detected by RT-PCR, followed up for 28 days, and the survival of the patients was recorded. Pearson correlation analysis was used to examine the relationship between miR-29a and miR-10a-5p and creatinine creatinine (creatinine) in the observation group. The correlation between cystatin Con Cys-Cand renal injury molecule 1 (KIM-1); Multivariate Logistic regression analysis of miR-29a1 miR-10a-5pScr-C was performed. KIM-1 and other risk factors in patients with sepsis. D the value of miR-29a, miR-10a-5p, Cys-C and Scr in evaluating the prognosis of sepsis patients was compared with that of miR-29a and miR-10a-5p by .ROC curve analysis. Finally, the value of miR-29a and miR-10a-5p combined with Scr and Cys-C in evaluating the prognosis of sepsis patients was analyzed by statistical method. 1 among 74 AKI patients, 21 died. 35.53% of the total population; (2) compared with the survival group, the expression of Scr and Cys-C in the serum of the patients with death was higher than that of the patients with death, and the expression of miR-29a and miR-10a-5p in the serum of the patients with death was higher than that of the patients with death. There was statistical significance (P 0.05). Pearson correlation analysis showed that miR-29a and miR-10a-5p were positively correlated with the expression of Cys-C and KIM-1, respectively. Multivariate regression analysis showed that both miR-29a and miR-10a-5p were independent risk factors for death in sepsis patients. The results of ROC curve analysis showed that the area under the miR-29a and miR-10a-5p curves was 0.82% 95 CI, respectively. The area under the Cys-CU SCR and KIM-1 curves was 0.72c95CI. 0.66-0.86 ~ 0.71 ~ (95) CI = 0.63-0.84) and 0.81 ~ (95) CI. The au ROC value of the combined detection of 0.72-0.81g 路miR-29a and miR-10a-5p was better than that of miR-29a / miR-10a-5p detected by single detection. Conclusion miR-29a and miR-10a-5p have a good predictive value in evaluating the mortality of sepsis patients.
【作者單位】： 重慶市中醫(yī)院重癥醫(yī)學(xué)科;
【分類(lèi)號(hào)】：R459.7;R692

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