Huo Rui, Dai Min, Fan Yi, Zhou Jing-Zheng, Li Li, Zu Jian
Department of Critical Care Medicine, Chongqing Chinese Medicine Hospital, Chongqing 400000, China.E-mail:
Nan Fang Yi Ke Da Xue Xue Bao. 2017 May 20;37(5):646-651. doi: 10.3969/j.issn.1673-4254.2017.05.13.
To investigate the value of miR-29a and miR-10a-5p in predicting 28-day mortality in patients with sepsis-induced acute kidney injury.
Seventy-four patients with sepsis-induced acute kidney injury (AKI) and 41 patients with sepsis but without AKI (control) were examined for serum levels of miR-29a and miR-10a-5p using RT-PCR. The patients were followed up for 28 days to record their survival. Pearson correlation analysis was used to test the correlations of miR-29a and miR-10a-5p with serum creatinine (Scr), cystatin C (Cys-C), and KIM-1 in patients with AKI. Multivariate logistic regression analysis was used to analyze the correlations of miR-29a, miR-10a-5p, Scr, Cys-C, KIM-1 and other risk factors with the 28-day mortality in patients with sepsis. The predictive value of these indicators for evaluating the prognosis of patients with sepsis was analyzed using ROC curve, and miR-29a combined with miR-10a-5p was assessed for their value in predicting the prognosis of the patients.
During the follow-up for 28 days, 21 of the 74 (35.53%) AKI patients died. Compared with the survivors, the patients died within 28 days showed significantly increased serum levels of Scr , Cys-C, KIM-1, miR-29a, and miR-10a-5p (P<0.05). Pearson correlation analysis showed that miR-29a and miR-10a-5p were positively correlated with serum Scr, Cys-C, and KIM-1 levels; multivariate regression analysis identified miR-29a and miR-10a-5p as the independent risk factors for mortality in the septic patients. The ROC curve analysis showed that the area under the curve (AUC) of miR-29a and miR-10a-5p was 0.82 (95%CI: 0.71-0.89) and 0.75 (95%CI: 0.64-0.85), and that of Scr, Cys-C and KIM-1 was 0.72 (95%CI: 0.66-0.86) , 0.71 (95% CI: 0.63-0.84) and 0.81 (95% CI: 0.72-0.81), respectively. The AUC of miR-29a combined with miR-10a-5p was significantly greater than that of miR-29a, miR-10a-5p, Scr, Cys-C and KIM-1 alone (P<0.05).
miR-29a and miR-10a-5p have good predictive value in assessing the 28-day mortality of patients with sepsis.
探讨miR-29a和miR-10a-5p在预测脓毒症诱导的急性肾损伤患者28天死亡率中的价值。
采用RT-PCR检测74例脓毒症诱导的急性肾损伤（AKI）患者和41例脓毒症但无AKI患者（对照组）血清中miR-29a和miR-10a-5p水平。对患者进行28天随访以记录其生存情况。采用Pearson相关性分析检测miR-29a和miR-10a-5p与AKI患者血清肌酐（Scr）、胱抑素C（Cys-C）和肾损伤分子-1（KIM-1）的相关性。采用多因素logistic回归分析分析miR-29a、miR-10a-5p、Scr、Cys-C、KIM-1及其他危险因素与脓毒症患者28天死亡率的相关性。采用ROC曲线分析这些指标对评估脓毒症患者预后的预测价值，并评估miR-29a联合miR-10a-5p对患者预后的预测价值。
在28天随访期间，74例AKI患者中有21例（35.53%）死亡。与存活患者相比，28天内死亡的患者血清Scr、Cys-C、KIM-1、miR-29a和miR-10a-5p水平显著升高（P<0.05）。Pearson相关性分析显示，miR-29a和miR-10a-5p与血清Scr、Cys-C和KIM-1水平呈正相关；多因素回归分析确定miR-29a和miR-10a-5p为脓毒症患者死亡的独立危险因素。ROC曲线分析显示，miR-29a和miR-10a-5p的曲线下面积（AUC）分别为0.82（95%CI：0.71-0.89）和0.75（95%CI：0.64-0.85），Scr、Cys-C和KIM-1的AUC分别为0.72（95%CI：0.66-0.86）、0.71（95%CI：0.63-0.84）和0.81（95%CI：0.72-0.81）。miR-29a联合miR-10a-5p的AUC显著大于单独的miR-29a、miR-10a-5p、Scr、Cys-C和KIM-1（P<0.05）。
miR-29a和miR-10a-5p在评估脓毒症患者28天死亡率方面具有良好的预测价值。
