Xu Lixia, Li Jingpo, Li Li, Zhang Qiushuang, Feng Qiuju, Bai Lijie
Department of Oncology Nursing, Hebei General Hospital, Hebei, China.
Department of Urology Nursing, Hebei General Hospital, Hebei, China.
Microbiol Immunol. 2025 May;69(5):297-306. doi: 10.1111/1348-0421.13210. Epub 2025 Mar 16.
Sepsis-associated acute kidney injury (AKI) poses a severe threat to patients' lives and health, making early predictions, intervention, and treatment crucial. This study aims to preliminarily explore the clinical role of miR-577 and miR-494-3p in sepsis-associated AKI. The study included 70 sepsis patients with AKI, 65 sepsis patients without AKI, and a healthy control group (HC, n = 67) to set baseline miRNA levels. Urinary miR-577 and miR-494-3p levels were measured using qRT-PCR. ROC curves evaluated their diagnostic value for sepsis-associated AKI. Logistic regression analyzed AKI risk factors, while Pearson correlation explored miRNA-clinical indicator links. Cox regression models and KM curves assessed the prognostic value of miRNAs in sepsis-associated AKI patients. Sepsis-associated AKI patients showed heightened inflammatory markers, renal indicators, and APACHE II scores compared to those without AKI. However, their urinary miR-577 and miR-494-3p levels were notably lower, distinguishing them with high diagnostic value. These miRNAs inversely correlated with inflammatory markers, renal indicators, and severity scores. Logistic regression showed lactate, PCT, BUN, Scr, Cys-C, NGAL, KIM-1, and APACHE II, as risk factors, while miR-577 and miR-494-3p were protective. In deceased sepsis-associated AKI patients, these miRNAs were lower, with higher inflammatory markers, renal indicators, and severity scores. miR-577 and miR-494-3p independently predicted mortality, with lower expressions linked to higher death rates. miR-577 and miR-494-3p are closely related to sepsis-associated AKI and can serve as potential biomarkers for diagnosis and prognostic assessment.
脓毒症相关急性肾损伤（AKI）对患者的生命和健康构成严重威胁，因此早期预测、干预和治疗至关重要。本研究旨在初步探讨miR-577和miR-494-3p在脓毒症相关AKI中的临床作用。该研究纳入了70例脓毒症合并AKI患者、65例无AKI的脓毒症患者以及一个健康对照组（HC，n = 67），以设定基线miRNA水平。采用qRT-PCR检测尿中miR-577和miR-494-3p水平。ROC曲线评估它们对脓毒症相关AKI的诊断价值。逻辑回归分析AKI的危险因素，而Pearson相关性分析则探索miRNA与临床指标之间的联系。Cox回归模型和KM曲线评估miRNA在脓毒症相关AKI患者中的预后价值。与无AKI的患者相比，脓毒症相关AKI患者的炎症标志物、肾脏指标和APACHE II评分更高。然而，他们尿中的miR-577和miR-494-3p水平明显更低，具有较高的诊断价值。这些miRNA与炎症标志物、肾脏指标和严重程度评分呈负相关。逻辑回归显示乳酸、降钙素原、血尿素氮、血肌酐、胱抑素C、中性粒细胞明胶酶相关脂质运载蛋白、肾损伤分子-1和APACHE II为危险因素，而miR-577和miR-494-3p具有保护作用。在死亡的脓毒症相关AKI患者中，这些miRNA水平更低，炎症标志物、肾脏指标和严重程度评分更高。miR-577和miR-494-3p可独立预测死亡率，表达水平较低与较高的死亡率相关。miR-577和miR-494-3p与脓毒症相关AKI密切相关，可作为诊断和预后评估的潜在生物标志物。
