AGI危重患者血清miR-10b-5p、miR-200b-3p、miR-34a-5p水平及三者联合模型对胃肠道损伤程度的预测价值OA

Objective To investigate the serum levels of microRNA(miR)-10b-5p,miR-200b-3p and miR-34a-5p in critically ill patients with acute gastrointestinal injury(AGI),and to evaluate the predictive value of the combined model of the three indicators for gastrointestinal injury severity.Methods A total of 304 pa-tients with AGI admitted to the hospital from February to October 2023 were enrolled as the study group,and 215 healthy individuals underwent physical examination during the same period were included as the control group.In addition,167 critically ill AGI patients admitted from December 2023 to June 2024 were selected as the validation group for external validation.According to the severity of gastrointestinal injury,patients were divided into a gastrointestinal dysfunction group and a gastrointestinal failure group.Baseline data of AGI pa-tients were collected.Serum levels of miR-10b-5p,miR-200b-3p and miR-34a-5p were detected by real-time quantitative reverse transcription PCR.Multivariate Logistic regression analysis was performed to identify fac-tors influencing gastrointestinal injury severity.Receiver operating characteristic(ROC)curve was construc-ted to evaluate the diagnostic value of miR-10b-5p,miR-200b-3p and miR-34a-5p for the degree of gastrointes-tinal injury in critically ill AGI patients.Results The serum levels of miR-10b-5p,miR-200b-3p and miR-34a-5p in the study group were significantly lower than those in the control group(P<0.05).Among the 304 pa-tients in the study group,183 cases were classified into the gastrointestinal dysfunction group and 121 cases into the gastrointestinal failure group.The levels of serum miR-10b-5p,miR-200b-3p and miR-34a-5p in the gastrointestinal failure group were lower than those in the gastrointestinal dysfunction group,while the levels of blood lactate and C-reactive protein were higher than those in the gastrointestinal dysfunction group,and the differences were all statistically significant(P<0.05).Multivariate Logistic regression analysis results showed that increased levels of miR-10b-5p,miR-200b-3p and miR-34a-5p were all protective factors for gas-trointestinal failure in critically ill patients with AGI(P<0.05).ROC curve analysis results showed that the areas under the curves(AUCs)of miR-10b-5p,miR-200b-3p and miR-34a-5p alone and in combination of the three indicators for predicting gastrointestinal failure in critically ill patients with AGI were 0.806,0.763,0.787 and 0.917 respectively,and the AUC of the combined prediction of the three indicators for gastrointestinal failure in critically ill AGI patients was significantly larger than that of each indicator alone(P<0.05).The results of external validation showed that the AUC of the combined model of serum miR-10b-5p,miR-200b-3p and miR-34a-5p in predicting gastrointestinal failure in AGI patients was 0.911,with a sensitivity of 82.54%and a specificity of 88.46%.Conclusion Serum levels of miR-10b-5p,miR-200b-3p and miR-34a-5p are de-creased in critically ill patients with AGI,and their combined model has high clinical predictive value for gas-trointestinal injury severity.