[1]霍锐,戴敏,樊艺,等.miRNA-29a和miRNA-10a-5p 对脓毒症所致急性肾损伤患者28 d 死亡率的预测价值[J].南方医科大学学报,2017,(05):646.
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miRNA-29a和miRNA-10a-5p 对脓毒症所致急性肾损伤患者28 d 死亡率的预测价值()
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《南方医科大学学报》[ISSN:1673-4254/CN:44-1627/R]

卷:
期数:
2017年05期
页码:
646
栏目:
出版日期:
2017-05-20

文章信息/Info

Title:
Predictive value of miRNA-29a and miRNA-10a-5p for 28-day mortality in patients with sepsis-induced acute kidney injury
作者:
霍锐戴敏樊艺周竞峥李莉祖建
关键词:
脓毒症miR-29amiR-10a-5p急性肾损伤生存率
Keywords:
sepsis miR-29amiR-10a-5pacute kidney mortality
摘要:
目的探讨miR-29a和miR-10a-5p对评估脓毒症伴有急性肾损伤(AKI)患者28 d死亡率的预测价值。方法收集我院124 例急性肾损伤患者(AKI)血清样本,分为观察组(74例脓毒症所致AKI)和对照组(脓毒症无AKI)41例,记录患者一般情况,并 用RT-PCR检测其中miR-29a和miR-10a-5p的表达情况,随访28 d,记录患者生存情况,采用Pearson相关分析检验miR-29a和 miR-10a-5p 与观察组患者血清肌酐(Scr)、胱抑素C(Cys-C)和肾损伤分子1(KIM-1)的相关性;多因素Logistic 回归分析 miR-29a、miR-10a-5p、Scr、Cys-C、KIM-1以及其他危险因素与脓毒症患者28 d死亡率的相关性。ROC曲线分析比较miR-29a 和miR-10a-5p与Cys-C和Scr在脓毒症患者预后评估中的价值,最后进一步用统计学方法分析miR-29a和miR-10a-5p联合与 Scr及Cys-C联合对脓毒症患者预后评估的价值。结果随访28 d后:(1)74例AKI患者中21例死亡,占整体人数的35.53%;(2) 相比于生存组,死亡组患者血清Scr及Cys-C表达上升(P<0.05),死亡组患者血清中miR-29a和miR-10a-5p表达升高,有统计学 意义(P<0.05);(3)Pearson相关分析结果显示miR-29a和miR-10a-5p分别与Scr、Cys-C及KIM-1表达呈正相关;(4)多因素回归 结果显示,miR-29a和miR-10a-5p均为脓毒症患者死亡的独立危险因素;(5)ROC曲线分析结果显示miR-29a和miR-10a-5p曲 线下面积(auRoC)分别为0.82(95%CI,0.71-0.89)及0.75(95%CI,0.64-0.85),Cys-C、Scr和KIM-1曲线下面积分别为0.72(95% CI,0.66-0.86)、0.71(95%CI,0.63-0.84)及0.81(95%CI,0.72-0.81)。miR-29a及miR-10a-5p二者联合检测的auROC值优于单一 检测miR-29a、miR-10a-5p、Cys-C、Scr和KIM-1(P<0.05)。结论miR-29a和miR-10a-5p在评估脓毒症患者死亡率时具有良好 的预测价值。
Abstract:
Objective To investigate the value of miR-29a and miR-10a-5p in predicting 28-day mortality in patients with sepsis-induced acute kidney injury. Methods 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. Result 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). Conclusion miR-29a and miR-10a-5p have good predictive value in assessing the 28-day mortality of patients with sepsis.

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更新日期/Last Update: 1900-01-01