Han Y Y, Wang C Y, Yang L, Zhao G Y, Liu H L, Li J Z, Chen P L, Cui K
Department of Intensive Care, First People's Hospital of Shangqiu City (Shangqiu Clinical College, Xuzhou Medical University), Shangqiu 476100, China.
Medical Intensive Care Unit, Peking Union Medical College Hospital, Beijing 100730, China.
Zhonghua Yi Xue Za Zhi. 2020 Jul 21;100(27):2126-2131. doi: 10.3760/cma.j.cn112137-20200103-00016.
To investigate the significance of microRNA (miR)-216a, miR-324-5p, miR-29a expression in peripheral blood in patients with acute pancreatitis (AP) and their correlation with liver injury. It was a case-control study design. To select 130 AP patients admitted from June 2017 to May 2019 in the First People's Hospital of Shangqiu, and the patients were divided into mild AP group (MAP group) and moderately severe AP group (SAP group) according to the disease severity, or 54 patients in the liver injury group (20 were MAP and 34 were SAP) and 76 in the non-liver injury group(all were MAP) according to liver injury. And another 40 healthy volunteers were selected as the healthy group. The expressions of miR-216a, miR-324-5p and miR-29a in peripheral blood of MAP group, SAP group, healthy group and liver injury group, non-liver injury group were compared, and the correlation between the miRNA levels and clinical indexes was analyzed. The predictive value of miRNA levels in peripheral blood for AP complicated with liver injury was analyzed by receiver operating characteristic (ROC) curve. The levels of miR-216a and miR-29a in MAP group and SAP group were higher than those in healthy group, and the level of miR-324-5p was lower than that in healthy group (all 0.01). The levels of miR-216a and miR-29a in SAP group were higher than those in MAP group, and the level of miR-324-5p was lower than that in healthy group (all 0.01). Balthazar CT Score, acute physiology and chronic health evaluations (APACHE Ⅱ) score, C-reactive protein level, length of hospital stay were positively correlated with the levels of miR-216a and miR-29a in peripheral blood (all 0.05), and negatively correlated with the levels of miR-324-5p (0.05). The levels of miR-216a and miR-29a in the peripheral blood in the liver injury group were higher than those in the non-liver injury group, and they were higher inSAP patients than those in MAP patients in the liver injury group (all 0.05). The level of miR-324-5p in the peripheral blood in the liver injury group was lower than that in the non-liver injury group, and it was lower in SAP patients than that in MAP patientsin the liver injury group (all 0.05). The area under ROC curve of miR-216a, miR-324-5p, and miR-29a in peripheral blood to predicate the AP complicated with liver damage was 0.694, 0.750 and 0.814, respectively. The levels of miR-216a and miR-29a increase in peripheral blood and the level of miR-324-5p decreases in patients with AP, and they are closely related to Balthazar CT score, APACHEⅡ score, C-reactive protein and length of hospital stay. The levels of miR-216a, miR-324-5p, miR-29a has certain predictive value for AP with liver injury, of which miR-29a has the highest predictive value.
探讨微小RNA（miR）-216a、miR-324-5p、miR-29a在外周血中的表达在急性胰腺炎（AP）患者中的意义及其与肝损伤的相关性。本研究采用病例对照研究设计。选取2017年6月至2019年5月在商丘市第一人民医院收治的130例AP患者，根据病情严重程度分为轻症AP组（MAP组）和中重症AP组（SAP组），或根据肝损伤情况分为肝损伤组54例（其中MAP 20例，SAP 34例）和非肝损伤组76例（均为MAP）。另选取40例健康志愿者作为健康组。比较MAP组、SAP组、健康组以及肝损伤组、非肝损伤组外周血中miR-216a、miR-324-5p和miR-29a的表达，并分析miRNA水平与临床指标的相关性。采用受试者工作特征（ROC）曲线分析外周血miRNA水平对AP合并肝损伤的预测价值。MAP组和SAP组中miR-216a和miR-29a水平高于健康组，miR-324-5p水平低于健康组（均P<0.01）。SAP组中miR-216a和miR-29a水平高于MAP组，miR-324-5p水平低于健康组（均P<0.01）。Balthazar CT评分、急性生理与慢性健康状况评价系统（APACHEⅡ）评分、C反应蛋白水平、住院时间与外周血中miR-216a和miR-29a水平呈正相关（均P<0.05），与miR-324-5p水平呈负相关（P<0.05）。肝损伤组外周血中miR-216a和miR-29a水平高于非肝损伤组，且肝损伤组中SAP患者高于MAP患者（均P<0.05）。肝损伤组外周血中miR-324-5p水平低于非肝损伤组，且肝损伤组中SAP患者低于MAP患者（均P<0.05）。外周血中miR-216a、miR-324-5p和miR-29a预测AP合并肝损伤的ROC曲线下面积分别为0.694、0.750和0.814。AP患者外周血中miR-216a和miR-29a水平升高，miR-324-5p水平降低，且它们与Balthazar CT评分、APACHEⅡ评分、C反应蛋白及住院时间密切相关。miR-216a、miR-324-5p、miR-29a水平对AP合并肝损伤具有一定的预测价值，其中miR-29a预测价值最高。
