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循环凝血相关 microRNAs 表达对持续非卧床腹膜透析患者主要心脑不良事件风险的预测价值:一项队列研究。

Predictive value of circulating coagulation related microRNAs expressions for major adverse cardiac and cerebral event risk in patients undergoing continuous ambulatory peritoneal dialysis: a cohort study.

机构信息

Division of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, 26 Shengli Street, Jiang'an District, Wuhan, 430014, China.

Department of Respiration, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

J Nephrol. 2020 Feb;33(1):157-165. doi: 10.1007/s40620-019-00626-x. Epub 2019 Jul 29.

Abstract

BACKGROUND

We aimed to investigate the correlation of coagulation related microRNAs (miRNAs) expressions with major adverse cardiac and cerebral event (MACCE) risk in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).

METHODS

198 end-stage renal disease (ESRD) patients underwent CAPD were consecutively recruited in this study. Clinical characteristics as well as physiological and biochemical indexes were recorded. Peripheral blood was collected after enrollment to separate plasma, and 13 blood coagulation related miRNAs were detected by the real-time quantitative polymerase chain reaction. All patents were followed up for 48 months, and the last follow-up date was 2018/12/31. MACCEs occurred during the follow up were documented, and MACCE-free survival was calculated.

RESULTS

MACCE incidence at 1 year, 2 year, 3 year and 4 year was 2.5, 6.1, 9.1 and 13.1% respectively, and mean MACCE-free survival was 45.2 (95% CI 44.0-46.4) months. Kaplan-Meier curves showed that miR-30e-5p, miR-92a-3p, miR-106a-5p and miR-126-5p high expressions were associated with longer MACCE-survival, while miR-423-5p high expression correlated with shorter MACCE-free survival. Multivariate Cox's regression analysis disclosed that miR-92a-3p, miR-126-5p and miR-652-3p independently predicted longer MACCE-free survival, while miR-423-5p independently predicted reduced MACCE-free survival in CAPD patients.

CONCLUSION

Circulating miR-92a-3p, miR-126-5p, miR-652-3p and miR-423-5p exhibit potential to serve as novel biomarkers for MACCE risk in patients undergoing CAPD.

摘要

背景

本研究旨在探讨持续性非卧床腹膜透析(CAPD)患者凝血相关 microRNAs(miRNAs)表达与主要不良心脑事件(MACCE)风险的相关性。

方法

连续纳入 198 例终末期肾病(ESRD)患者行 CAPD,记录临床特征及生理生化指标。入组后采集外周血分离血浆,实时定量聚合酶链反应检测 13 种凝血相关 miRNA。所有患者均随访 48 个月,末次随访日期为 2018 年 12 月 31 日。记录随访期间 MACCE 的发生情况,计算 MACCE 无事件生存率。

结果

1 年、2 年、3 年和 4 年 MACCE 发生率分别为 2.5%、6.1%、9.1%和 13.1%,平均 MACCE 无事件生存率为 45.2(95%CI 44.0-46.4)个月。Kaplan-Meier 曲线显示 miR-30e-5p、miR-92a-3p、miR-106a-5p 和 miR-126-5p 高表达与较长的 MACCE 生存时间相关,而 miR-423-5p 高表达与较短的 MACCE 无事件生存时间相关。多因素 Cox 回归分析显示,miR-92a-3p、miR-126-5p 和 miR-652-3p 独立预测 CAPD 患者 MACCE 无事件生存时间延长,而 miR-423-5p 独立预测 MACCE 无事件生存时间缩短。

结论

循环 miR-92a-3p、miR-126-5p、miR-652-3p 和 miR-423-5p 有望成为预测 CAPD 患者 MACCE 风险的新型生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5c1/7007420/5973354bf9c0/40620_2019_626_Fig1_HTML.jpg

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