• 血清miR-150、IL-18水平有助于评估脓毒症休克患者的预后
  • 吴梅秋.血清miR-150、IL-18水平有助于评估脓毒症休克患者的预后[J].内科急危重症杂志,2021,27(6):487-492
    DOI:10.11768/nkjwzzzz20210611
    中文关键词:  微小RNA-150  白细胞介素-18  脓毒症休克  预后
    英文关键词:
    基金项目:
    作者单位E-mail
    吴梅秋 海南医学院第一附属医院 wuqiumei5927@163.com 
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    中文摘要:
          摘要 目的:探讨脓毒症休克患者血清中微小RNA-150(miR-150)、白细胞介素-18(IL-18)水平,与脓毒症休克的关系。方法:选取2017年3月-2020年3月海南医学院第一附属医院住院的脓毒症患者115例,按照病情严重程度分为脓毒症组(83例)和脓毒症休克组(32例),选取同期体检健康者120例作为对照组。根据3个月预后结果将脓毒症休克组患者分为预后良好组(23例)和预后不良组(9例)。采用实时荧光定量PCR(qRT-PCR)法检测所有受试者血清miR-150水平,采用酶联免疫吸附试验(ELISA)检测所有受试者血清IL-18水平,Pearson分析脓毒症休克组患者miR-150、IL-18水平与实验室指标及评分的相关性,采用Logistic回归分析影响脓毒症休克患者预后的因素。结果:对照组、脓毒症组、脓毒症休克组白细胞计数(WBC)、C反应蛋白(CRP)、丙氨酸转氨酶(ALT)、降钙素原(PCT)水平依次升高,血小板计数(PLT)水平依次降低(P均<0.05);脓毒症休克组病程长于脓毒症组;天门冬氨酸转氨酶(AST)、中性粒细胞与淋巴细胞比值(NLR)、序贯器官功能衰竭评估(SOFA)评分、急性生理与慢性健康状态评估(APACHE Ⅱ)评分高于脓毒症组(P均<0.05);对照组、脓毒症组、脓毒症休克组血清miR-150表达水平依次降低,而IL-18水平依次升高(P均<0.05);脓毒症休克组患者miR-150与CRP、NLR、SOFA评分、APACHEⅡ评分、IL-18呈负相关(P均<0.05);IL-18与WBC、CRP、NLR、APACHE Ⅱ评分呈正相关,与PLT呈负相关(P均<0.05);与预后良好组比较,预后不良组血清miR-150表达水平更低,IL-18水平更高(P均<0.05);血清CRP、IL-18高水平及miR-150低水平是影响脓毒症休克患者预后的危险因素。结论:脓毒症休克患者血清中miR-150呈低表达、IL-18呈高表达,且与患者不良预后有一定关系。
    英文摘要:
          Abstract Objective: To investigate the serum microRNA-150 (miR-150) and interleukin-18 (IL-18) levels in patients with septic shock and their relationship with septic shock. Methods: A total of 115 patients with sepsis admitted to the First Affiliated Hospital of Hainan Medical College from March 2017 to March 2020 were selected and divided into sepsis group (83 cases) and sepsis shock group (32 cases) according to the severity of the disease. Totally, 120 healthy people in the same period were selected as the control group. According to the 3-month prognosis, the patients in septic shock group were divided into good prognosis subgroup (23 cases) and poor prognosis subgroup (9 cases). The serum miR-150 levels were detected by quantitative real-time PCR (qRT-PCR), and serum IL-18 levels were detected by enzyme-linked immunosorbent assay (ELISA). Pearson was used to analyze the correlation between miR-150, IL-18 levels and laboratory indexes and scores in septic shock group, and Logistic regression was used to analyze the prognostic factors of patients with septic shock. Results: The leukocyte count, C-reactive protein (CRP), alanine aminotransferase (ALT) and procalcitonin (PCT) in control group, sepsis group and sepsis shock group increased in turn, and the level of platelet count (PLT) decreased in turn (all P< 0.05). The course of sepsis shock group was longer than that of sepsis group, and the aspartate aminotransferase (AST), the ratio of neutrophils to lymphocytes (NLR), sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score were higher than those in sepsis group (P all<0.05); the expression level of serum miR-150 decreased in control group, sepsis group and sepsis shock group, while the level of IL-18 increased in turn (P all< 0.05); in septic shock group, miR-150 was negatively correlated with CRP, NLR, SOFA score, APACHE Ⅱ score and IL-18 (P all< 0.05); IL-18 was positively correlated with leukocyte count, CRP, NLR and APACHE Ⅱ scores, and negatively correlated with PLT (P all< 0.05).The expression level of serum miR-150 was lower and the level of IL-18 was higher in the poor prognosis subgroup than in the good prognosis subgroup (P all< 0.05).High levels of serum CRP, IL-18 and low levels of miR-150 were risk factors affecting the prognosis of patients with septic shock. Conclusion: The expression of miR-150 was low and IL-18 was high in patients with septic shock, which was related to the poor prognosis of patients.