外周血miR-155水平对脓毒症及肠道功能障碍患者28d死亡风险的预测价值OA
Predictive value of peripheral blood miR-155 levels on the risk of death at 28 d in patients with sepsis and intestinal dysfunction
目的:分析外周血中 microRNA-155(miR-155)浓度对脓毒症及其并发肠道功能障碍患者28 d内死亡风险的预测价值.方法:本研究聚焦于新疆医科大学第一附属医院重症医学中心收治的129例脓毒症病例,Lgistic回归模型探究外周血中miR-155表达量与肠道功能障碍发生之间的关联性.根据患者28 d内的生死状态,将样本分为存活组(n=93)与死亡组(n=36).采用Cox比例风险模型识别影响脓毒症患者预后结果的风险因素,并构建受试者工作特征曲线(ROC),以评价外周血miR-155表达水平在预测脓毒症患者预后方面的效能.此外,利用Kaplan-Meier生存分析法,依据不同的miR-155表达水平绘制生存曲线,深入分析生存状况.结果:脓毒症患者的外周血miR-155表达量升高是诱发肠道功能障碍的风险因素(OR=3.156,95%CI=1.875~5.311,P<0.001).与存活组相比,死亡组患者外周血中miR-155的表达水平明显升高(P<0.001).Cox比例风险回归分析进一步确认,miR-155是独立影响脓毒症患者预后结果的一个关键因素.通过受试者ROC曲线分析发现,miR-155表达水平在预测脓毒症患者28 d死亡风险时,AUC=0.962,显示高预测准确性.当设定miR-155的截断值为3.95时,预测的敏感度为93.9%,特异度为90.2%.Kaplan-Meier生存曲线分析进一步揭示,对于 miR-155表达水平超过 3.95的患者,其预后情况明显较差(P<0.001).结论:作为一种简便、高效且安全的生物标志物,外周血中miR-155具有临床潜力,可用于预测及早期预后评估脓毒症及其所致的肠道损伤.
Objective:To analyze the predictive value of peripheral blood microRNA-155(miR-155)concentration on the risk of death within 28 days in patients with sepsis and intestinal dysfunction.Methods:This study focused on 129 cases of sepsis ad-mitted to the Critical Medicine Center of the First Affiliated Hospital of Xinjiang Medical University.Logistic regression model was used to explore the correlation between the expression of miR-155 in peripheral blood and the occurrence of intestinal dysfunc-tion.According to the life and death status of patients within 28 days,the samples were divided into the survival group(n=93)and the death group(n=36).Cox proportional risk model was used to identify the risk factors affecting the prognosis of sepsis pa-tients,and the receiver operating characteristic curve(ROC)of the subjects was constructed based on this model to evaluate the ef-ficacy of peripheral blood miR-155 expression level in predicting the prognosis of sepsis patients.In addition,Kaplan-Meier surviv-al analysis was used to draw survival curves according to different miR-155 expression levels for in-depth survival analysis.Re-sults:The increased expression of miR-155 in peripheral blood of patients with sepsis was a risk factor for induced intestinal dys-function(OR=3.156,95%CI=1.875‒5.311,P<0.001).Compared to the survival group,the expression level of miR-155 in peripheral blood of patients in the death group was significantly increased(P<0.001).Cox proportional hazard regression analysis further confirmed that miR-155 was a key factor independently affecting the prognosis of sepsis patients.According to the ROC curve analysis,the AUC of miR-155 expression level was 0.962 when predicting the 28-day death risk of sepsis patients,indicat-ing a high prediction accuracy.When the cut-off value of miR-155 was set to 3.95,the predicted sensitivity reached 93.9%and the specificity was 90.2%.Kaplan-Meier survival curve analysis further revealed that patients with miR-155 expression levels above 3.95 had a significantly worse prognosis(P<0.001).Conclusions:As a simple,efficient,and safe biomarker,miR-155 in periph-eral blood has clinical potential in the prediction and early prognosis assessment of sepsis and intestinal injuries caused by sepsis.
李志华;银乐乐;杨春波;于湘友;高晓明;王毅
新疆医科大学第一附属医院重症医学中心,新疆 乌鲁木齐 830054新疆医科大学第五附属医院,新疆 乌鲁木齐 830000新疆医科大学第一附属医院重症医学中心,新疆 乌鲁木齐 830054新疆医科大学第一附属医院重症医学中心,新疆 乌鲁木齐 830054新疆医科大学动物模型研究重点实验室,新疆 乌鲁木齐 830054新疆医科大学第一附属医院重症医学中心,新疆 乌鲁木齐 830054
医药卫生
脓毒症肠道功能障碍miR-15528d死亡风险
SepsisIntestinal dysfunctionmiR-15528-day mortality risk
《海南医科大学学报》 2026 (8)
624-630,7
This study was supported by the National Natural Science Foundationof China(82160360)Natural Science Foundation Project of Xinjiang Uygur Autonomous Region(2022D01C477)14th Five Year Plan for National Key Research and Development Program of China(2021YFC25000801) 国家自然科学基金(82160360)新疆维吾尔自治区自然科学基金(2022D01C477)"十四五"国家重点研发计划(2021YFC25000801)
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