【摘要】：目的：本研究通過microRNA芯片技術(shù)篩選膿毒癥相關血清microRNA。通過實時熒光定量PCR技術(shù)驗證部分差異表達的血清microRNA，并初步探討其對膿毒癥的診斷價值。 方法：以入住呼吸重癥監(jiān)護病房（RICU）、急診重癥監(jiān)護病房（EICU）的膿毒癥病人和非膿毒癥病人為研究對象。收集病人的臨床資料，采集病人入選時的血清樣本，膿毒癥病人好轉(zhuǎn)后再次采集血清樣本。應用microRNA芯片技術(shù)比較3例病人膿毒癥階段和好轉(zhuǎn)后血清microRNA表達水平差異，初步篩選膿毒癥相關血清microRNA。擴大臨床樣本量至20例膿毒癥病人，應用實時熒光定量PCR技術(shù)驗證部分差異表達的microRNA，并比較膿毒癥病人(n=95)與非膿毒癥病人(n=66)所篩選出的血清microRNA表達水平的差異，初步探討其診斷價值。 結(jié)果：（1）microRNA芯片篩選的樣本為3例確診的細菌感染的膿毒癥病人的血清，比較其膿毒癥階段和好轉(zhuǎn)后的血清樣本，，篩選出差異表達microRNA共20個。（2）擴大樣本量至20例膿毒癥病人，應用實時熒光定量PCR對hsa-miR-3591-5p、hsa-miR-501-5p和hsa-let-7d-3p進行了驗證，其中hsa-let-7d-3p在膿毒癥階段和治療好轉(zhuǎn)階段有統(tǒng)計學差異。（3）通過比較95例膿毒癥病人和66例非膿毒癥病人的血清hsa-let-7d-3p水平，顯示膿毒癥組顯著高于非膿毒癥對照組。采用logistic回歸校正膿毒癥組與對照組在性別、年齡、白細胞計數(shù)、C反應蛋白、APACHEⅡ評分、SOFA評分、是否為創(chuàng)傷病人、是否接受有創(chuàng)機械通氣、是否應用升壓藥物的差異后，血清hsa-let-7d-3p水平仍有統(tǒng)計學差異。受試者工作特征曲線（ROC）分析顯示血清hsa-let-7d-3p診斷膿毒癥的ROC曲線下面積為0.696(95%置信區(qū)間[0.615,0.778])。 結(jié)論：應用microRNA芯片比較病人膿毒癥階段與好轉(zhuǎn)階段的血清樣本，初步篩選了膿毒癥相關血清microRNA。血清hsa-let-7d-3p與膿毒癥的相關性得到了熒光定量PCR的證實，血清hsa-let-7d-3p有可能作為新的膿毒癥預警診斷標志物。
[Abstract]:Objective: to screen serum microRNA. related to sepsis by microRNA chip technique. Some differentially expressed serum microRNA, was verified by real-time fluorescence quantitative PCR and its diagnostic value in sepsis was preliminarily discussed. Methods: sepsis patients and non-sepsis patients admitted to respiratory intensive care unit (RICU),) emergency intensive care unit (EICU) were studied. The clinical data of the patients were collected, the serum samples were collected when the patients were selected, and the serum samples were collected again after the sepsis patients improved. MicroRNA microarray technique was used to compare the expression of microRNA in serum of 3 patients with sepsis and after improvement, and the serum microRNA. related to sepsis was screened preliminarily. The clinical sample size was expanded to 20 sepsis patients. Real-time fluorescence quantitative PCR was used to verify the partial differentially expressed microRNA, and to compare the difference of serum microRNA expression between sepsis patients (n 鈮

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