[1]苏一星,袁 华,周守志,等.血清微小核糖核酸-133a、微小核糖核酸-126、髓系细胞表达触发受体-1、肺表面活性蛋白A表达水平与脓毒症并发急性呼吸窘迫综合征风险及预后关系[J].陕西医学杂志,2024,(7):978-982.[doi:DOI:10.3969/j.issn.1000-7377.2024.07.025]
　SU Yixing,YUAN Hua,ZHOU Shouzhi,et al.Relationship between the expression levels of serum miR-133a,miR-126,TREM-1 and SP-A and the risk and prognosis of ARDS complicated with sepsis[J].,2024,(7):978-982.[doi:DOI:10.3969/j.issn.1000-7377.2024.07.025]
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血清微小核糖核酸-133a、微小核糖核酸-126、髓系细胞表达触发受体-1、肺表面活性蛋白A表达水平与脓毒症并发急性呼吸窘迫综合征风险及预后关系
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年7期
页码:
978-982
栏目:
临床检验
出版日期:
2024-07-05

文章信息/Info

Title:
Relationship between the expression levels of serum miR-133a,miR-126,TREM-1 and SP-A and the risk and prognosis of ARDS complicated with sepsis
作者:
苏一星; 袁 华; 周守志; 黄小明; 夏晓华
(昆山市第一人民医院急诊医学科,江苏 昆山 215301)
Author(s):
SU Yixing; YUAN Hua; ZHOU Shouzhi; HUANG Xiaoming; XIA Xiaohua
(Department of Emergency Medicine,the First People's Hospital of Kunshan,Kunshan 215301,China)
关键词:
脓毒症;  急性呼吸窘迫综合征;  微小核糖核酸-133a;  微小核糖核酸-126;  髓系细胞表达触发受体-1;  肺表面活性蛋白A;  预后
Keywords:
Sepsis;  Acute respiratory distress syndrome;  microRNA-133a;  microRNA-126;  Myeloid cells express trigger receptor-1;  Pulmonary surfactant protein A;  Prognosis
分类号:
R 563
DOI:
DOI:10.3969/j.issn.1000-7377.2024.07.025
文献标志码:
A
摘要:
目的:研究血清微小核糖核酸-133a(miR-133a)、微小核糖核酸-126(miR-126)、髓系细胞表达触发受体-1(TREM-1)、肺表面活性蛋白A(SP-A)表达水平与脓毒症并发急性呼吸窘迫综合征(ARDS)风险及预后的关系。方法:将248例脓毒症患者根据其是否发生ARDS分为无ARDS组(97例)和ARDS组(151例),统计两组血清miR-133a、miR-126、TREM-1、SP-A表达水平; 分别根据脓毒症并发ARDS患者病情严重程度及入院后28 d预后情况将其分为轻度组(51例)、中度组(73例)、重度组(27例)及存活组(122例)、死亡组(29例),比较不同病情严重程度及预后脓毒症并发ARDS患者血清miR-133a、miR-126、TREM-1、SP-A表达水平。采用受试者工作特征曲线(ROC)分析血清miR-133a、miR-126、TREM-1、SP-A对脓毒症并发ARDS患者预后的预测价值。结果:ARDS组血清miR-133a、miR-126、TREM-1表达水平高于无ARDS组,血清SP-A表达水平低于无ARDS组(均P<0.05)。轻度组、中度组、重度组血清miR-133a、miR-126、TREM-1表达水平呈升高趋势,血清SP-A表达水平呈降低趋势,组间比较差异具有统计学意义(均P<0.05)。死亡组血清miR-133a、miR-126、TREM-1表达水平高于存活组,血清SP-A表达水平低于存活组(均P<0.05)。血清miR-133a、miR-126、TREM-1、SP-A联合预测脓毒症并发ARDS患者预后的曲线下面积(AUC)值高于四者单独检测(均P<0.05); 敏感度比较,血清SP-A、TREM-1高于血清miR-133a、miR-126及联合检测,血清SP-A高于血清TREM-1,联合检测高于血清miR-133a、miR-126(均P<0.05); 特异度比较,血清miR-133a高于血清TREM-1、SP-A及联合检测,血清miR-126、联合检测高于血清TREM-1、SP-A(均P<0.05)。结论:血清miR-133a、miR-126、TREM-1、SP-A表达水平与脓毒症并发ARDS患者病情的发生和发展均关系密切,四者联合对脓毒症并发ARDS患者预后具有较好的预测效果。
Abstract:
Objective:To investigate the relationship between the expression levels of serum microRNA-133a(miR-133a),microRNA-126(miR-126),myeloid cell expression triggering receptor-1(TREM-1),pulmonary surfactant protein A(SP-A)and the risk and prognosis of acute respiratory distress syndrome(ARDS)complicated by sepsis.Methods:248 patients with sepsis were divided into a group without ARDS(97 cases)and a group with ARDS(151 cases)according to whether they had ARDS.Serum expression levels of miR-133a,miR-126,TREM-1 and SP-A in the two groups were analyzed.According to the severity of sepsis complicated with ARDS and the prognosis 28 d after admission,the patients were divided into the mild group(51 cases),the moderate group(73 cases),the severe group(27 cases)and the survival group(122 cases),the death group(29 cases).To compare the expression levels of miR-133a,miR-126,TREM-1 and SP-A in serum of ARDS patients with sepsis complicated with different severity and prognosis.The predictive value of serum miR-133a,miR-126,TREM-1 and SP-A on the prognosis of ARDS patients with sepsis was analyzed by receiver operating characteristic curve(ROC).Results:The expression levels of miR-133a,miR-126 and TREM-1 in the non-ARDS group were higher than those in the ARDS group,and the expression level of SP-A in the ARDS group was lower than that in the non-ARDS group(all P<0.05).The expression levels of serum miR-133a,miR-126 and TREM-1 in the mild groups,the moderate groups and the severe groups were increased,while the expression level of serum SP-A was decreased(all P<0.05).The expression levels of serum miR-133a,miR-126 and TREM-1 in the death group were higher than those in the survival group,and the expression level of serum SP-A was lower than that in the survival group(all P<0.05).The area under the curve(AUC)value of serum miR-133a,miR-126,TREM-1 and SP-A combined to predict prognosis of ARDS patients with sepsis was higher than that of the four alone(all P<0.05).Sensitivity comparison showed that serum SP-A and TREM-1 were higher than serum miR-133a,miR-126 and combination,and serum SP-A was higher than serum TREM-1 and combined with serum miR-133a and miR-126(all P<0.05).The specificity of serum miR-133a was higher than that of serum TREM-1,SP-A and combination,and that of serum miR-126 and combination was higher than that of serum TREM-1 and SP-A(all P<0.05).Conclusion:The expression levels of serum miR-133a,miR-126,TREM-1 and SP-A are closely related to the occurrence and development of sepsis complicated with ARDS patients,and the combination of the four have a good predictive effect on the prognosis of sepsis complicated with ARDS patients.

参考文献/References:

[1] FOWLER A R,TRUWIT J D,HITE R D,et al.Effect of vitamin C infusion on organ failure and biomarkers of inflammation and vascular injury in patients with sepsis and severe acute respiratory failure:The citris-ali randomized clinical trial[J].JAMA,2019,322(13):1261-1270.
[2] FANG Q,WANG Q,ZHOU Z,et al.Consensus analysis via weighted gene co-expression network analysis(wgcna)reveals genes participating in early phase of acute respiratory distress syndrome(ards)induced by sepsis[J].Bioengineered,2021,12(1):1161-1172.
[3] 杨燕,刘德智.FGD5-AS1调控miR-133a-3p对脓毒症血管内皮细胞的细胞活性、凋亡及炎症因子表达的影响[J].中国免疫学杂志,2021,37(17):2076-2081.
[4] 吴智慧,吴卫江,郑洁,等.重症颅脑损伤患者继发肺部感染病原菌及其血清miR-34a和miR-126与miR-16的诊断价值[J].中华医院感染学杂志,2023,33(12):1828-1832.
[5] 邓飞,张勇钱,陈英夫,等.血必净结合CBP治疗与ICU脓毒症患儿恢复情况及sTREM-1、Treg水平的关系研究[J].中国中西医结合肾病杂志,2022,23(10):898-900.
[6] 王星,刘辉,庞辉,等.血清SAA、YKL-40及SP-A的联合检测对小儿难治性肺炎支原体肺炎的预测价值分析[J].现代生物医学进展,2023,23(7):1309-1314.
[7] SINGER M,DEUTSCHMAN C S,SEYMOUR C W,et al.The third international consensus definitions for sepsis and septic shock(sepsis-3)[J].JAMA,2016,315(8):801-810.
[8] 马晓春,王辰,方强,等.急性肺损伤/急性呼吸窘迫综合征诊断和治疗指南(2006)[J].中国危重病急救医学,2006,18(12):706-710.
[9] WANG Q L,YANG L,LIU Z L,et al.Sirtuin 6 regulates macrophage polarization to alleviate sepsis-induced acute respiratory distress syndrome via dual mechanisms dependent on and independent of autophagy[J].Cytotherapy,2022,24(2):149-160.
[10] OKAZAKI T,KAWAKAMI D,FUJITANI S,et al.Potential interaction between sepsis and acute respiratory distress syndrome and effect on the 6-month clinical outcomes:A preliminary secondary analysis of a prospective observational study[J].J Intensive Care Med,2023,38(1):60-69.
[11] 徐宁,贾娟,李莉,等.血清miRNA-125b联合miRNA-133a早期诊断脓毒症合并急性呼吸窘迫综合征的价值[J].中国临床研究,2023,36(4):537-541.
[12] 梁敏,李弯,熊诗思,等.miR-133a-3p靶向调控CD2AP基因减轻RSV感染的人支气管上皮细胞系16-HBE损伤[J].基础医学与临床,2021,41(10):1463-1469.
[13] 徐娜,崔云飞,叶玲,等.心律失常合并医院感染患者外周血 miR-126-5p和miR-133a表达水平[J].中华医院感染学杂志,2022,32(5):708-712.
[14] 林润,李乐辉,吴国平,等.循环miR-126表达水平与脓毒症患者发生ARDS的风险及脓毒症严重程度和预后的关联[J].重庆医科大学学报,2020,45(11):1583-1588.
[15] 张晶,代思华,王晓岩,等.CRNDE调节miR-126-5p减弱患儿脓毒症脑损伤的机制研究[J].河北医药,2021,43(14):2101-2105.
[16] 张节平,孙京焕,吴文娟,等.肺部感染相关急性呼吸窘迫综合征影响因素及其miRNA表达水平[J].中华医院感染学杂志,2020,30(23):3622-3625.
[17] 刘广精,王光权,黎天皇.乌司他丁联合依诺肝素治疗脓毒症并发急性肺损伤临床疗效及安全性研究[J].陕西医学杂志,2023,52(8):1071-1075.
[18] 刁冰冰,梁群.化纤胶囊Ⅱ号方治疗脓毒症急性肺损伤疗效及对患者血管内皮细胞功能、毛细血管渗漏指数的影响[J].陕西中医,2023,44(1):45-49,59.
[19] 张琪,姜利,席修明,等.血清TRAF-6、MCP-1、sTREM-1、IL-33水平与脓毒症严重程度及与合并急性肾损伤关系的临床分析[J].现代生物医学进展,2019,19(23):4440-4444.
[20] 鲁杰,马国祥,熊纭辉,等.连续性肾脏替代治疗对老年脓毒症患者血清可溶性髓系细胞触发受体-1、T淋巴细胞亚群水平及预后的影响[J].临床内科杂志,2020,37(4):287-290.
[21] 李喆,刘金华,何龙培,等.参附注射液联合高容量血液滤过对脓毒症诱发急性呼吸窘迫综合症患者的治疗效果及血清Ang-2、SP-D水平的影响[J].广州中医药大学学报,2022,39(10):2249-2255.
[22] 李小鸥,黄红丽,方成志.支气管肺泡灌洗液炎性因子及肺泡表面活性蛋白与新生儿急性呼吸窘迫综合征的关系[J].中华实用诊断与治疗杂志,2022,36(8):809-813.
[23] 陈国忠,周成杰,姚滔,等.触发受体-1和可溶性内皮细胞间黏附分子-1对脓毒症严重程度和预后的评估价值[J].中国卫生检验杂志,2019,29(17):2092-2095.
[24] 张瑜,王娟.脓毒症并发急性呼吸窘迫综合征患者血清血管内皮钙黏蛋白、血管生成素2表达及与预后相关性研究[J].陕西医学杂志,2022,51(2):176-179,190.
[25] 解拥军,童永忠,王洁.血清可溶性髓系细胞触发受体-1在脓毒症中的诊断价值[J].热带医学杂志,2020,20(10):1308-1311.

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备注/Memo

备注/Memo:
基金项目:江苏省医院协会医院管理创新专项研究课题(JSYGY-3-2021-JZ65)
更新日期/Last Update: 2024-07-04