重症肺炎患者血清miR-24和miR-223水平的变化及其临床价值
Changes and Clinical Value of Serum miR-24 and miR-223 Levels in Patients with Severe Pneumonia.
作者信息
Gao Lin, Liu Qindi, Zhang Weiwei, Sun Hong, Kuang Zhiming, Zhang Guangping, Huang Zhenfei
机构信息
Department of Intensive Care Unit, Ganzhou People's Hospital, Ganzhou City, Jiangxi Province, 341000, People's Republic of China.
Department of Respiratory and Critical Medicine, Ganzhou Fifth People's Hospital, Ganzhou City, Jiangxi Province, 341000, People's Republic of China.
出版信息
Int J Gen Med. 2023 Aug 28;16:3797-3804. doi: 10.2147/IJGM.S411966. eCollection 2023.
INTRODUCTION
Severe pneumonia progresses rapidly, so early assessment of the severity and prognosis is crucial for reducing mortality rates.
OBJECTIVE
We explore the role of serum microRNA-24 (miR-24) and microRNA-223 (miR-223) in the prognosis of severe pneumonia.
METHODS
There were a total of 96 patients with general pneumonia, 94 patients with severe pneumonia, and 93 healthy people, who were enrolled in this study. The levels of serum miR-24 and miR-223 were detected by real-time fluorescent quantitative PCR in all groups.
RESULTS
The serum miR-223 level in the severe group was higher than that in the common group and the control group, and the miR-24 level was lower than that in the common group and the control group (P<0.05). The serum miR-223 levels and APACHEII scores in the death group were higher than those in the survival group on the first, third, and seventh day after admission, while the miR-24 levels were lower than those in the survival group (P<0.05). The proportion of patients with mechanical ventilation in the death group was higher than that in the survival group (P<0.05). The level of serum miR-24 was negatively correlated with APACHEII score and mechanical ventilation in patients who died of severe pneumonia (P<0.05), and miR-223 was positively correlated with APACHEII score and mechanical ventilation (P<0.05). The AUC predicted by serum miR-24, miR-223, and APACHEII scores alone and jointly were 0.867, 0.839, 0.791, and 0.952, respectively. MiR-24 and miR-223 are protective and independent risk factors for mortality in severe pneumonia patients, respectively (P<0.05). MiR-24 was a protective factor affecting the death of patients with severe pneumonia, and miR-223 was an independent risk factor affecting the death of patients with severe pneumonia (P<0.05).
CONCLUSION
The combination of serum miR-24 and miR-223 levels on the first day after admission and APACHEII score can effectively predict prognosis.
引言
重症肺炎进展迅速，因此早期评估病情严重程度及预后对于降低死亡率至关重要。
目的
探讨血清微小RNA-24（miR-24）和微小RNA-223（miR-223）在重症肺炎预后中的作用。
方法
本研究共纳入96例普通肺炎患者、94例重症肺炎患者和93例健康人。采用实时荧光定量PCR检测所有组血清miR-24和miR-223水平。
结果
重症组血清miR-223水平高于普通组和对照组，miR-24水平低于普通组和对照组（P<0.05）。死亡组入院后第1天、第3天和第7天的血清miR-223水平及急性生理与慢性健康状况评分系统II（APACHEII）评分均高于存活组，而miR-24水平低于存活组（P<0.05）。死亡组机械通气患者比例高于存活组（P<0.05）。重症肺炎死亡患者血清miR-24水平与APACHEII评分及机械通气呈负相关（P<0.05），miR-223与APACHEII评分及机械通气呈正相关（P<0.05）。血清miR-24、miR-223及APACHEII评分单独及联合预测的曲线下面积（AUC）分别为0.867、0.839、0.791和0.952。miR-24和miR-223分别是重症肺炎患者死亡的保护因素和独立危险因素（P<0.05）。miR-24是影响重症肺炎患者死亡的保护因素，miR-223是影响重症肺炎患者死亡的独立危险因素（P<0.05）。
结论
入院后第1天血清miR-24和miR-223水平联合APACHEII评分可有效预测预后。
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